This document is a supplement to the Queensland Clinical Guideline (QCG) Intrapartum pain
management. It provides supplementary information regarding guideline development, makes
summary recommendations, suggests measures to assist implementation and quality activities and
summarises changes (if any) to the guideline since original publication. Refer to the guideline for
abbreviations, acronyms, flow charts and acknowledgements.
Consultation
Major consultative and development processes occurred between August 2022 and February 2023.
Table 4. Major guideline development processes
Process Activity
Clinical leads • The nominated co-clinical leads were approved by QCG Steering
Committee
Consumer
participation
• Consumer participation was invited from a range of consumer focused
organisations who had previously accepted an invitation for on-going
involvement with QCG
Working party
• An EOI for working party membership was distributed via email to
Queensland clinicians and stakeholders in July 2022
• The working party was recruited from responses received
• Working party members who participated in the working party consultation
processes are acknowledged in the guideline
• Working party consultation occurred in a virtual group via email
Statewide
consultation
• Consultation was invited from Queensland clinicians and stakeholders
during November 2022–December 2022
• Feedback was received primarily via email
• All feedback was compiled and provided to the clinical lead and working
party members for review and comment
Recommendations
1.
Commence psychoeducation in the antenatal period:
• Discuss labour pain in the context of a purposeful, normal physiological event, to
enhance self-efficacy and lessen fear
• Offer evidence-based information about pain management strategies to inform the
woman’s decision making
2. Consider additional support and/or referral to multidisciplinary team for women with
anxiety, trauma, or fear of childbirth
3. Actively support women’s preferences and choices for pain management in labour
4. Promote the use of non-pharmacological methods that offer benefits with no/few side
effects
5. If using opioid analgesia, morphine or fentanyl are the preferred systemic opioids for
labour analgesia
6.
If neuraxial analgesia:
• Use lower concentrations of local anaesthetics for epidural analgesia to minimise the
effect on perinatal outcomes (e.g. prolonged second stage, assisted birth)
• Develop/follow local guidelines to conduct a mobility assessment prior to utilising
active positioning, in line with the woman’s preference
7. Discuss, assess and review the woman’s satisfaction with pain management during
labour and following birth
Implementation
This guideline is applicable to all Queensland public and private maternity facilities. It can be
downloaded in Portable Document Format (PDF) from www.health.qld.gov.au/qcg