Women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour

Abstract

Pain during labour is a complex and subjective experience shaped by physiological, psychological, and social factors. Non-pharmacological approaches to pain have been widely recognised as safe and supportive of physiological birth. Despite this, their utilisation in clinical practice remains inconsistent, suggesting a gap between evidence, policy, and practice. Hence this critical literature review aims to explore women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour. The research question for this review is; What are women’s knowledge and attitudes towards non-pharmacological pain relief methods during labour? A systematic search of the literature was conducted using CINAHL, PubMed, MEDLINE, and Scopus to identify peer-reviewed studies published in the English language between 2020 and 2025. The main key words included ‘women’, ‘labour’, ‘pain relief’, ‘non-pharmacological’, ‘knowledge’, and ‘attitudes. Inclusion criteria focused on primary research examining women’s understanding and perceptions of non-pharmacological pain relief during labour. Following a structured screening process, six studies with various methodologies were selected to address the research question. Methodological quality was critically appraised using Joanna Briggs Institute tools, ensuring a consistent evaluation of study rigour and potential bias. The review identified three main findings: (1) inconsistent and limited knowledge, with women relying on informal information sources (2) positive attitudes towards non-pharmacological methods, in relation to control, autonomy, and a natural birth experience; and (3) the significant influence of healthcare professionals, cultural context, and the birth setting. Despite favourable attitudes, limited knowledge and health system barriers, including a predominance of medicalised care, were found to restrict implementation in practice. This review highlights a clear disparity between the recognised benefits of non-pharmacological pain relief and their underutilisation in maternity care. It recommends the need for improved antenatal education, strengthened midwifery support, and organisational changes to promote woman-centred care. Further research is recommended to generate more robust and generalisable evidence to inform practice and policy.