Quality standard

Quality statement 3: Pain relief

Quality statement

Women who have their labour induced have access to pain relief that is appropriate to their level of pain and to the type of pain relief they request.

Rationale

It is important for all women in labour that they receive appropriate pain relief within a suitable timeframe. As induced labour is usually more painful than spontaneous labour, women whose labour is induced may need pain relief earlier than women whose labour starts spontaneously. Women's needs for pain relief, and for different types of pain relief, may vary. Pain relief that is appropriate and suitable for the woman should be available, along with comfort and support that may be provided by partners, family members and others.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements for women who have their labour induced to have access to pain relief that is appropriate to their level of pain and to the type of pain relief they request.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from service protocols.

Outcome

Women who had induction of labour are satisfied that the pain relief they received was appropriate to their level of pain and to the type of pain relief they requested.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from surveys of women who had induction of labour.

What the quality statement means for different audiences

Service providers ensure that access is available, for women whose labour is induced, to pain relief that is appropriate to their level of pain and to the type of pain relief they request.

Healthcare professionals ensure that women whose labour is induced have access to pain relief that is appropriate to their level of pain and to the type of pain relief they request.

Commissioners ensure that they commission services that provide women whose labour is induced with access to pain relief that is appropriate to their level of pain and to the type of pain relief they request.

Women who have induction of labour (labour that is started artificially, for example, using a pessary, tablet or gel) are offered pain relief that is appropriate for the amount of pain they are experiencing and the type of pain relief they request.

Source guidance

Inducing labour. NICE guideline NG207 (2021), recommendation 1.5.8

Definitions of terms used in this quality statement

Appropriate pain relief

Induced labour is usually more painful than spontaneous labour. It follows that 'appropriate' in this context refers to whether the type of pain relief is satisfactory and if it is given within a suitable timeframe. [Adapted from NICE's full guideline on inducing labour and expert opinion]

For women who are offered induction of labour the pain relief options available are those outlined in NICE's guideline on intrapartum care, along with comfort that may be provided by partners, family members and others. This can include simple analgesia, labour in water and epidural analgesia. [Adapted from NICE's guideline on inducing labour, recommendation 1.5.8]

Equality and diversity considerations

All women, including those with physical, sensory or learning disabilities and women who do not speak or read English, should have access to support such as an interpreter or advocate to help them express their needs for pain relief.