Background Pain during birth process is acknowledged for good progress of labour but severe, unbearable pain cause reduced effectiveness of contractions and lead to maternal exhaustion and fetal distress. Non pharmacological and pharmacological pain relief methods can be implemented to assist the women to cope with pain during labour. Non-pharmacological and pharmacological pain relief is available in the hospital, but it is not understood when and how labour pain is assessed and pain relief implemented. Research questions What is the current workplace culture relating to pain management during the first stage of labour? What alternative strategies can be implemented to address the current workplace culture relating to pain management during the first stage of labour? Research design and methods A qualitative design was followed. Convenience sampling was used and 18 observations on pain management during labour were done. Midwives taking care of women during labour took part in the research and their informed consent was obtained beforehand. Data was collected during unstructured observations of pain management during labour. Data was analysed by means of the creative hermeneutic data analysis method. Main findings Four themes were derived from the data: pain assessment, isolation, therapeutic environment and documentation. Based on these themes, strategies for improving pain management during labour were identified collaboratively. / Dissertation (MCur)--University of Pretoria, 2017. / Nursing Science / PhD / Unrestricted