Pain Science Education for Labour and Postpartum Pain

This Delphi study aims to establish expert consensus on the role, content, and delivery of pain science education (PSE) for labour and postpartum pain management. Despite the growing application of PSE in other populations, its use in maternity care remains underexplored. Through a three-round electronic Delphi survey, multidisciplinary experts-including physiotherapists, midwives, gynaecologists, pain specialists, nurses, and psychologists-will contribute their perspectives to guide the development of a structured PSE intervention for future clinical testing.

Labour pain is a critical and complex experience that can significantly influence both immediate and long-term maternal outcomes. Although antenatal education often addresses pain minimally or inconsistently, pain science education (PSE)-which reconceptualizes pain as a biopsychosocial phenomenon-has demonstrated benefits in other clinical contexts, such as chronic pain and musculoskeletal rehabilitation. PSE may reduce fear, enhance coping strategies, and support physiological birth outcomes. However, its integration into maternity care, particularly during labour and postpartum periods, has yet to be defined. This study employs a three-round electronic Delphi (e-Delphi) methodology to gain consensus on the use of PSE in this context. The Delphi method is ideal for topics where empirical evidence is limited but expert opinion is available. Guided by established best practices including the CREDES (Guidance on Conducting and REporting DElphi Studies) this study ensures methodological rigour and transparency. Multidisciplinary experts will be purposively recruited internationally via professional networks and social media platforms. To participate, experts must be English-speaking adults with relevant clinical experience or academic contributions in PSE, pain management, or antenatal education. The study will include physiotherapists, midwives, gynaecologists, psychologists, nurses, and pain specialists. Participants will be provided with detailed study information and will give informed consent electronically. The Delphi process will be conducted in three iterative rounds, allowing experts to respond anonymously to survey items, review aggregate group feedback, and refine their views. This method aims to identify convergence in expert perspectives and clarify the key components of a future PSE intervention for labour and postpartum care. Data will be analysed using NVivo for qualitative responses and SPSS for quantitative analysis. The outcome of this study will inform the development of a clearly defined, evidence-informed PSE intervention to be tested in future clinical trials. It represents an important step toward improving antenatal education and enhancing pain management during and after childbirth.

Inclusion Criteria: * Age 18 years or older * Ability to read and write in English * Professional background as one of the following: Registered physiotherapist Registered midwife Gynaecologist Pain management specialist Nurses Psychologist Exclusion Criteria: * Inability to read or write in English * Lack of relevant professional background or clinical experience as outlined in the inclusion criteria * Decline or fail to provide informed consent * Under 18 years of age