Effect of Mentorship on Midwives' Knowledge and Use of Non-Pharmacological Techniques in Managing Labour Pains: A Quasi-Experimental Study in Mukono District, Uganda

Abstract

Background: Effective management of labour pains is critical in enhancing maternal satisfaction, reducing complications, and improving birth outcomes. Despite global endorsements by the World Health Organization (WHO), non-pharmacological techniques (NPTs) such as massage, positional changes, and warm/cold compresses remain underutilized in the management of labour pain in low-resource settings like Uganda. This underutilization is attributed to systemic knowledge gaps and institutional constraints. Methodology: A quasi-experimental (pre-post intervention) design was conducted, among 46 midwives, from health Centre III, IV, and a general hospital. Participants underwent a three-month mentorship program on evidence-based NPTs, and the WHO intrapartum guidelines. Data were collected using validated questionnaires and observation checklists, and analyzed using SPSS v20. Paired t-tests were used to assess changes in knowledge, while chi-square tests evaluated associations of knowledge with demographics. Results: Before the intervention, 58.7% of midwives demonstrated inadequate knowledge of NPTs. Warm/cold compress was the least known (21.7%) and least used (23.9%) method. Post-intervention, mean knowledge scores increased significantly from 45.59 (SD=17.04) to 80.07 (SD=19.10) (p<0.0001). Knowledge and practice of warm/cold compress had the most increase (270% increase for knowledge and 81.8% increase in practice). Years of experience and profession were associated with the change in knowledge (x2=10.1, p=0.01 for experience; x2=14.2, p=0.02 for profession). Conclusion: Mentorship improved midwives' knowledge and use of NPTs, with the most notable change observed in the application of warm/cold compress. The findings aligned with the theory of planned behaviour, where knowledge and skill enhancement increased participants perceived behavioural control and self-efficacy. Recommendation: Use of mentorship to support integration of NPTs into labour management is recommended to prevent prolonged labour and risks of birth asphyxia. Keywords: Mentorship, Labour pain management, non-pharmacological techniques, Midwives, Quasi-experimental study, Uganda.