A systematic review and meta-analysis on labour pain management methods utilization and its associated factors among obstetric caregivers in Ethiopia

Despite growing attention to maternal health, labour pain management remains a neglected aspect of obstetric care in Ethiopia. Existing studies in Ethiopia on labour pain management among obstetric caregivers (OCGs) provide some insights; their findings are often inconsistent, geographically limited, and lack national representativeness. We therefore conducted a systematic review and meta-analysis to examine the utilization of labour pain management methods and associated factors among obstetric caregivers in Ethiopia. This review included all observational, full-text, English-language, published, and gray studies that reported on labour pain management practices or associated factors among obstetric caregivers in Ethiopia, searched from July 1-September 12/2025. Studies were identified via a comprehensive search of MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, CINAHL, SCOPUS, and a direct Google search of international databases. Methodological quality and heterogeneity among the included studies was assessed using the Hoy D et al. risk of bias tool & I² statistic, respectively. Publication bias was checked using Egger’s and funnel plots. All statistical analyses were conducted using STATA version 17.0. Half of the included studies were rated as high quality. About 45.18% of OCGs utilized labour pain management methods (95% CI: 39.87–50.48). Utilization was higher among female OCGs (Adjusted Odd Ratio [AOR] = 1.90; 95% CI: 1.24–2.93), midwives (AOR = 1.50; 95% CI: 1.15–1.94), having adequate knowledge of labour pain (AOR = 2.61; 95% CI: 1.51–4.53), having received training on labour pain management (AOR = 3.05; 95% CI: 2.17–4.30), working in facilities with adequate supplies (AOR = 5.43; 95% CI: 2.90-10.14), the presence of labour pain management protocol (AOR = 2.06; 95% CI: 1.46–2.90), and perceiving of labour pain as moderate to severe (AOR = 2.21; 95% CI: 1.40–3.49). Fewer than one in two OCGs utilized labour pain management methods. Individual caregiver characteristics (sex, profession, knowledge) and institutional factors (protocols, supplies, training) were associated with labour pain relief utilization among obstetric caregivers.