Table 1 Summary of findings

• Telling women to change lying positions

• Instructions to women to open mouths and take a deep breath

• Encourage movements like walking

Encouragements and instructions on exercises, position changing and deep mouth breathing

Non-pharmacological approaches used by nurse-midwives in managing labour pain

• Talking to women about labour prepares their mind

• Telling women are going to deliver safely

• Telling women to tolerate pain

Providing psychological support

• Rubbing women back

• Massaging women`s backs when not busy

• Massaging a woman`s back when in contraction

Performing a back massage

• Doing what one`s love doing

• Motivation from my heart

• The desire comes from my inner heart

Nurse-midwives intrinsic motivation

Facilitators for using non-pharmacological methods in managing labour pain

• Knowing the NPMs

• Women appreciations

• Experience in using the methods

The comfort of nurse-midwives on using the methods

• NPMs relief pain

• Raise women`s confidence

• Reduces incidence of fetal distress

Understanding the usefulness and benefits of using NPMs

• The absence of labour is a sign of poor progress

• Relieving pain cause a delay to give birth

• Pain is viewed as necessary for a baby to come out

Misconceptions about labour pain relief

Myths and fears related to using non-pharmacological strategies to relieve labour pains

• Women feel disturbed

• Women do not accept

• Women never follow our instructions

Women may be uncomfortable with the methods

• The baby may fall

• The baby may fall on the floor

Fear of baby falling