Hitanshu Bhatt1, Sunil Pandya2, Geeta Kolar3, Praveen Kumar Nirmalan4. 1. DNB Student, Department of Obstetrics, Fernandez Hospital , Hyderabad, India . 2. Head and Consultant, Department of Anesthesia and Critical Care Services, Fernandez Hospital , Hyderabad, India . 3. Consultant, Department of Fetal Medicine and Obstetric Ultrasound, Fernandez Hospital , Hyderabad, India . 4. Head, Department of Women and Child Health Research, Fernandez Hospital , Hyderabad, India .
Abstract
BACKGROUND: Labour epidural analgesia is increasingly used as a means of pain relief for women during labour and delivery. The significant pain during labour and delivery can be terrifying for mothers-to-be and the prospect of relief from pain can help reduce fear of childbirth to an extent. However, it is not necessary that reduced fear of childbirth may lead to an increased satisfaction with the childbirth experience. AIM: To determine the influence of labour epidural analgesia (LEA) on the experience of childbirth in pregnant women at a tertiary care center in southern India Materials and Methods: A pre-post interventional non-randomized study design at a tertiary care perinatal institute that used the Wijma Delivery Expectation and Experience questionnaires to determine baseline expectations of labour and childbirth and the actual experience in pregnant women. Labour analgesia was provided on maternal request or demand. Total and domain scores were compared between the two groups using non-parametric tests and a generalized linear repeated measures model after adjusting for factors that were found significant in the bivariate model. RESULTS: The study included 235 pregnant women who opted for LEA and 219 pregnant women who opted against LEA. Overall, 37 (15.74%) of woman with LEA and 30 (13.70%) of women without LEA had a worse than expected experience of childbirth. Significant pain relief (p<0.001) was provided with LEA, however, the post-delivery scores did not differ significantly between the two groups (F=0.90, p=0.34) in a generalized linear repeated measures model. CONCLUSION: Maternal satisfaction with the process of childbirth is a complex dynamic that is not limited to the significant relief from pain provided by LEA.
BACKGROUND: Labour epidural analgesia is increasingly used as a means of pain relief for women during labour and delivery. The significant pain during labour and delivery can be terrifying for mothers-to-be and the prospect of relief from pain can help reduce fear of childbirth to an extent. However, it is not necessary that reduced fear of childbirth may lead to an increased satisfaction with the childbirth experience. AIM: To determine the influence of labour epidural analgesia (LEA) on the experience of childbirth in pregnant women at a tertiary care center in southern India Materials and Methods: A pre-post interventional non-randomized study design at a tertiary care perinatal institute that used the Wijma Delivery Expectation and Experience questionnaires to determine baseline expectations of labour and childbirth and the actual experience in pregnant women. Labour analgesia was provided on maternal request or demand. Total and domain scores were compared between the two groups using non-parametric tests and a generalized linear repeated measures model after adjusting for factors that were found significant in the bivariate model. RESULTS: The study included 235 pregnant women who opted for LEA and 219 pregnant women who opted against LEA. Overall, 37 (15.74%) of woman with LEA and 30 (13.70%) of women without LEA had a worse than expected experience of childbirth. Significant pain relief (p<0.001) was provided with LEA, however, the post-delivery scores did not differ significantly between the two groups (F=0.90, p=0.34) in a generalized linear repeated measures model. CONCLUSION: Maternal satisfaction with the process of childbirth is a complex dynamic that is not limited to the significant relief from pain provided by LEA.
Entities:
Keywords:
Childbirth; Delivery; Labour epidural analgesia; Maternal satisfaction; Pain relief
Authors: Johanna Joensuu; Hannu Saarijärvi; Hanna Rouhe; Mika Gissler; Veli-Matti Ulander; Seppo Heinonen; Paulus Torkki; Tomi Mikkola Journal: BMJ Open Date: 2022-05-09 Impact factor: 3.006