Coping strategies for labor pain, related outcomes and influencing factors: A systematic review

INTRODUCTION Laboring women's ability to cope with pain is likely to be dependent on a variety of inter-related factors, including the level of pain intensity, the nature of the environment and the perceived support. The aim of this systematic review was therefore to explore coping strategies used by laboring women, related outcomes and factors influencing coping with labor pain. METHODS A mixed-methods systematic review was undertaken. Electronic databases (Medline, EMBASE, CINAHL, Psyclnfo) were searched to identify eligible studies from December 2020 to November 2021. The quantitative findings were narratively synthesized and reported thematically. The final mixed-methods synthesis involved gathering qualitative and quantitative data and producing a set of synthesized findings. RESULTS Twenty-three studies were included. Three themes were identified: 1) definition of coping and types of coping strategies, including behavioral and cognitive based techniques; 2) coping strategies related outcomes, including improvements in self-efficacy and reduction of pain intensity, fear, anxiety, time of admission and labor duration; and 3) factors influencing coping with labor pain, including continuity of carer; environment; presence of a birth companion; cardiotocography monitoring; and antenatal education. CONCLUSIONS This systematic review provides midwives and healthcare professionals with information to recognize coping strategies spontaneously adopted by laboring women and promote the use of a variety of techniques, as required by individual needs and preferences. Midwives are also provided with up-to-date knowledge on coping strategies related outcomes and influencing factors, which they can utilize to guide evidence-based practice decision-making and facilitate women and families' informed choice.