TITLE:
Midwives’ Perspectives on Pain Management Practices among Post-Caesarean Section Mothers at the Women and Newborn Hospital, Lusaka, Zambia
AUTHORS:
Wahila Ruth, Simuunza Mbozi Patience, Makukula Kabinga Marjorie, Musenge Emmanuel, Kanyanta Mumba Michael, Chapima Fabian, Kalusopa Mwiinga Victoria, Mvula Manasseh, Malama Chileshe, Siandeke Joy Anita, Mwale Alex, Mwelwa Mbewe Martha, Banda Yolan, Chituta Joyce, Nelly Kalonga, Siwale Chileshe Mwaba
KEYWORDS:
Midwives, Perspectives, Pain Management Practices, Post-Caesarean Section, Postoperative Pain, Hospital
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.5,
May
19,
2026
ABSTRACT: Introduction: Postoperative pain following Caesarean Section is among the most common maternal complaints, with global reports indicating up to 89.8% of women experiencing it; 84.2% of which is moderate to severe within the first 24 hours. Uncontrolled pain can lead to multiple complications, including delayed recovery, prolonged hospitalization, poor wound healing, and long-term psychological distress. Therefore, midwives who play a key role in post-caesarean section pain management practices can provide critical insights that are important for improving the quality and effectiveness of care. Consequently, this study aimed to explore midwives’ perspectives on the management practices of pain among post-caesarean section mothers at the Women and Newborn Hospital in Lusaka, Zambia. Methodology: The study, conducted at the Women and Newborn Hospital postnatal wards in Lusaka, Zambia adopted a qualitative descriptive design. Data were collected by conducting 15 individual face-to-face interviews with midwives using open ended questions on their perspectives on pain management. The interviews were audio recorded and transcribed verbatim. Thematic data analysis was employed through a structured process involving initial coding of the data, development of themes, refinement and review of identified themes and interpretation of findings. Findings: We identified four key themes. The first theme, protocol-driven and structured pain management practices, reflects the midwives’ reliance on the institutional clinical protocols and standard procedures of post-caesarean section pain management. Midwives reported that they follow the hospital’s clinical guidelines and employ both pharmacological and non-pharmacological interventions for pain management. They viewed non-pharmacological pain management as supportive care but also perceived these interventions to have limitations, particularly their short-term effectiveness. In the second theme, midwives’ clinical role in pain assessment and education, the recurrent pattern identified reflects the midwives’ central role as assessors, educators and advocates in post-caesarean section management. Theme three, midwives’ perceived competence in post-caesarean section pain management reflects their self-perceived ability and limitations to manage the pain. The fourth theme, systemic and contextual challenges in managing pain including medication overuse risks, balancing safety and effective pain relief, patient alcohol use, cultural and language barriers, drug shortages, and inadequate staffing were viewed as a constraint in optimal pain management. Conclusion: Pain management for post caesarean section mothers at the University Teaching Hospitals is characterized by a structured multifaceted approach that integrates pharmacological and non-pharmacological strategies supported by midwives’ competence and adherence to protocols. While midwives perceived current practices as effective and well received, they highlighted significant challenges ranging from patient-related factors to systemic resource constraints that limit optimal pain control. Addressing these barriers through enhanced training, improved resource allocation, and culturally sensitive care is essential to strengthening pain management outcomes and promoting maternal recovery in this setting.