For a study, researchers wanted to investigate obstetricians’ attitudes on adopting professional or regulatory guidelines, opioid risk-screening instruments, and recommendations for nonanalgesic therapy for postpartum pain management. Semi-structured interviews with obstetric and maternal-fetal medicine physicians (N=38) from two large academic health care facilities in central Pennsylvania were conducted using a qualitative study methodology. An interview outline was utilized to facilitate the conversation regarding each physician’s ideas concerning pain treatment after delivery. The comments of physicians revealed three tendencies in the data: 1) 71% of physicians relied on clinical intuition rather than professional or regulatory guidelines to inform decisions about pain management after childbirth; 2) while many reported that a standard opioid patient screening tool would be useful to inform clinical decisions about pain management, nearly all (92%) physician respondents reported that they were not currently using one, and 3) 63% believed that nonpharmacologic pain management therapies should be used. Key physician hurdles to implementation (for example, a lack of time and evidence, a lack of knowledge on how to implement) and patient barriers to performance (for example, taking time away from other duties, a lack of time or patience) were also found.
These findings imply that obstetric doctors’ attitudes and clinical knowledge have an important impact on pain treatment decisions for women after delivery. To reduce exposure to prescription opioids after childbirth, practical and scalable strategies are needed to 1) encourage obstetric physicians to use professional or regulatory guidelines and standard opioid risk-screening tools to inform clinical decisions about pain management after childbirth; and 2) educate physicians and patients about nonopioid and nonpharmacologic pain management options.
