Labour pain management practices in a teaching tertiary hospital in Botswana: a cross-sectional study

Introduction: pain is a universal experience that can lead to distress, anxiety, depression, increased healthcare use, and even adverse outcomes. Labour pain is among the most severe types experienced by women and requires specialized treatment, yet its control remains underutilized in many low- and middle-income countries, including Botswana, where information on current practice is limited. Methods: a cross-sectional quantitative study on labour pain management practices among healthcare providers was conducted at Princess Marina Hospital from July to August 2025. Using a structured Self-administered questionnaire, data on demographics, analgesia practices, and barriers were collected from eligible providers and analysed using SPSS version-30. Results: among the 58 labour analgesia care providers invited, 56 providers responded (96.6%). Most were females (69.6%) and midwives (57.1%), aged 31-40 years (46.4%), with over 5 years of experience (57.1%). All obstetricians, and most residents (90.9%) and midwives (84.4%) provided counselling, mainly during labour (83.9%). Pharmacological and non-pharmacological methods were each used by 98.2% of providers. Common analgesics included pethidine (98.2%), paracetamol (50.0%), and morphine (19.6%), while deep breathing (82.1%), massaging (78.6%), and reassurance (69.6%) were common non-pharmacological methods. Only 26.8% of the care providers had formal training in labour pain management. The main barrier to effective analgesia was a lack of training, inadequate equipment and supplies, and fear of fetal distress. Conclusion: key barriers to labour pain management were inadequate training and a shortage of equipment and supplies. Enhancing capacity building, ensuring resource availability, and developing locally appropriate protocols could significantly improve labour analgesia service and its effective application.