Novel grouping of planned coping strategies for managing the intensity of labour: A qualitative study

Objective: It is common for women to explore and plan strategies to cope during labour. These strategies are usually focused on pain control and described as either pharmacological or non-pharmacological. As labour is an individual experience, each woman should be enabled to choose strategies that best suit them, and that reflect what they feel influences their sense of capacity to cope. By exploring women’s intentions and choices of strategies, this study aimed to understand how coping strategies can better reflect women’s individual needs and expectations. Design: Survey of 56 pregnant women, including open-ended questions. Setting: Australian tertiary maternity hospital. Population: Nulliparous women. Methods: Content and thematic analysis of open-ended responses. Main outcome measures: A qualitative description of women’s planned coping strategies for labour. Results: Themes related to how women frame the intensity of labour, how they strive for a relationally safe environment and a need to be prepared and knowledgeable. Strategies chosen by women could be grouped into two categories: intrinsic and extrinsic. Intrinsic strategies could be self-generated by women (such as breathing techniques and movement), while extrinsic strategies required either equipment (such as a bath) or others to administer (such as epidural analgesia). Conclusions: Women value having a range of intrinsic and extrinsic strategies that enable autonomy or require external support. This moves beyond the ‘pharmacological and non-pharmacological’ categorisation of strategies. The findings provide a foundation for more targeted research into how women can be supported to individualise and implement these coping strategies in labour.