Pharmacological and Non Pharmacological Labor Pain Management among Licensed Obstetric Care Providers in Ethiopia: Practice Patterns and Predictors from a Systematic Review and Meta-Analysis
Year: 2026
Type: preprint
Study designs: Systematic Review, Meta-Analysis
Abstract: Background Labor pain is a distinctive physiological and psychological experience requiring effective management to ensure respectful maternity care. Global guidelines recommend both labor pain management approaches, yet implementation in Ethiopia remains inconsistent. This review assessed the pooled prevalence and predictors of labor pain management practices (LPMPs) among licensed obstetric care providers (OCPs). Methods A comprehensive search was conducted across major databases and institutional repositories for studies published between 2018 and 2025. Critical appraisal used the Joanna Briggs Institute checklist and the modified Newcastle–Ottawa Scale. Meta‑analysis was performed in STATA 17, with heterogeneity assessed using Cochran’s Q and I². Pooled adjusted odds ratios (AORs) with 95% CI were calculated, and certainty of evidence rated using GRADE. Results Twenty studies were included, comprising 5,272 participants for non‑pharmacological LPMP (N‑PLPMP) and 3,586 for pharmacological LPMP (P‑PLPMP). The pooled prevalence of N‑PLPMP was 42.8%, whereas P‑PLPMP was 21.1%, decreasing to 15.2% after adjustment for publication bias. Knowledge, favorable attitudes, supportive environments, and managment protocol availability were consistently associated with N‑PLPMP. Certainty of evidence was moderate for N‑PLPMP and low for P‑PLPMP. Conclusions Both P&NPLPMPs remain suboptimal. Adoption of standardized protocols, strengthened training, and systemic support is essential to advance evidence‑based intrapartum care.
Source: Research Square
Authors: Wondu Feyisa Balcha, Tewodros Worku Bogale, Amanuel Tebabal Nega, Gebeyehu Masresha Teferi, Lewegneh Wegayehu Tessema, Eden Asmare Kassahun, Alemwork Abie Getu, Desalegn Getnet Demsie, Chernet Tafere Negesse, Kebede Feyisa, Biset Asrade Mekonnen, Tefera Minwagaw Biadigilign, Zenaw Debasu Addisu, Wondim Ayenew, Ebrahim Abdela Siraj, Segenet Zewdie, Yeniewa Kerie Anagaw, Gizachew Motbaynor Alene, Malede Berihun Yismaw, Adane Yehualaw Wendalem, Selamawit Yimer Kebede, Endalamaw Aschale Mihiretie, Simachew Animen Bante, Azimeraw Arega Tesfu, Berihun Assefa Demissie, Yonas Mengistu Abebe, Wondimagegn Genaneh Shiferaw, Solomon Medina Megule, Fikadu Waltengus Sendeku, Almaz Nibret Belay, Amlaku Mulat Awoke, Fentahun Alemnew Chekole
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203468692