Nurses’ Approaches to Pain Management for Women With Opioid Use Disorder in the Perinatal Period

• Published in: Journal of obstetric, gynecologic, and neonatal nursing Vol. 50; no. 4; pp. 412 - 423
• Main Authors: Renbarger, Kalyn M., Draucker, Claire Burke
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2021
• Subjects: nurse; Nursing; opioid use disorder; pain management; women; opioid use disorder; nurse; pain management; women
• ISSN: 0884-2175; 1552-6909
• DOI: 10.1016/j.jogn.2021.03.001

To identify how nurses approach pain management for women with opioid use disorder (OUD) in the perinatal period from the perspectives of nurses and women. A secondary analysis of data from a qualitative descriptive study on the development of trust between nurses and women who use substances during the perinatal period. We interviewed the woman participants in a private conference room at a residential treatment center, and we interviewed the nurse participants over the phone. Four women from a residential treatment center in the rural U.S. Midwest and nine nurses who were members of a local Midwestern Chapter of the Association of Women’s Health, Obstetric and Neonatal Nurses. We used semistructured individual interviews, and participants were asked to describe positive, negative, and typical interactions they had with the other group to identify factors that helped or hindered the formation of trust. In the course of the interviews, four of the women and nine of the nurses described interactions centered on pain management. This information, which we summarized using content analysis, provided data related to the approaches to pain management that nurses use for women with opioid use disorder in the perinatal period. Analysis showed that nurse participants used five approaches to pain management: Promoting Nonopioid Pain Management Strategies; Trying to Give Pain Medications on Time; Doubting or Judging Women; Withholding, Delaying, or Resisting Giving Pain Medications; and Responding to Women’s Hostility. Nurses should confront biases related to opioid use during pregnancy and receive training on how to manage aggressive behavior during the provision of maternity care. At times, participants approached pain management for women with opioid use disorder in the perinatal period in ways that were inconsistent with clinical guidelines and resulted in strained relationships.