CHAPTER ONE/INTRODUCTION
Pain during labor has been around since biblical times, when God cursed the first woman with it so that she would suffer during childbirth. It has been passed down down the ages from one generation to the next that the toil and discomfort of labor is ordained by God and ought to be suffered through rather than attempted to be alleviated (Aziato, Acheampong, & Umoar, 2017; Aziato, Odai, & Omenyo, 2016; Sruthi, 2013; Tarekegn, Lieberman, & Giedraitis, 2014). Undoubtedly, a lot of women have the misconception that labor and delivery are terrible and that every woman has to go through it, despite the fact that some women give birth without any discomfort at all (Ampofo & Caine, 2015; Czech et al., 2018). The pain that a woman experiences during labor is unlike any other pain, since it is caused by a combination of physiological and psychological processes taking place in her body (Beigi, Broumandfar, Bahadoran, & Abedi, 2010).
Both the experience of pain and its treatment involve a complex interplay of physiological and psychological elements, and are not exclusive to the nervous system (Czech et al., 2018; Klomp, Witteveen, de Jonge, Hutton, & Lagro-Janssen, 2017). During the first stage of labor, the parturient experiences pain from the uterus, cervix, pelvic joints, and ligaments. During the second stage of labor, the parturient experiences pain from the vagina and perineum due to the stretching of both structures to accommodate the foetus that will be born. This occurs because the vagina and perineum must stretch to accommodate the foetus. However, anxiousness and anxiety make the already distressing experience significantly worse (Czech et al., 2018; El-Wahab & Robinson, 2011; James, Prakash, & Ponniah, 2012; Marshall & Raynor, 2014; Sruthi, 2013). Labor is not a permanent experience; therefore, the alleviation of its pain is susceptible to a number of cultural and societal factors that are, however, subject to change. This is the case despite the changes in the body that are responsible for the beginning of labor pains (Almushait & Ghani, 2014).
It is a well-established fact that giving birth is one of the most excruciating events a woman will ever go through in her lifetime (Aziato, Kyei, & Deku, 2017; El-Wahab & Robinson, 2011; Hosseni, Pilevarzadeh, & Vazirinasab, 2016). The practice of using labor analgesia is encouraged by professionals in the domains of obstetrics and anesthesia all over the world in order to improve the experience of labor as a whole and to reduce the risk of any potential bad effects (Czech et al., 2018). In contrast to nations with higher incomes, labor pain relief is not a well-established service in Africa. This is especially true in countries with lower incomes, such as Uganda, where very little is known about the likelihood that laboring women would be amenable to receiving labor analgesia (Nabukenya , Kintu, Wabule, Muyingo, & Kwizera 2015)
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