Knowledge, attitudes and use of labour analgesia among women at a low-income country antenatal clinic

Abstract

BackgroundChildbirth is one of the most painful experiences of a woman’s life. Authorities in the fields of obstetrics and anaesthesia encourage use of labour analgesia. Unlike in high-income countries, pain relief in labour in Africa is not a well established service, especially in the low-income countries like Uganda. Little is known about whether parturients would be amenable to labour analgesia. We sought to determine knowledge, attitudes and use of labour analgesia among women attending the antenatal clinic at Mulago National Referral Hospital.MethodsUpon obtaining institutional approval, we conducted a cross-sectional descriptive study. Women were requested to complete the researcher-administered survey following informed consent. The study was conducted in the general antenatal clinic at the Mulago National Referral Hospital.ResultsOf 1293 participants interviewed, only 7 % of the participants had knowledge of labour analgesia. Of the multiparous mothers 87.9 % did not have labour analgesia in their previous deliveries, although 79.2 % of them had delivered in a national referral hospital. The commonest reason for refusal of labour analgesia was to experience natural childbirth. 87.7 % of the participants wanted labour analgesia for their next delivery.ConclusionThere is a wide gap between the desire for labour analgesia and its availability. Obstetricians and anaesthesiologists have a role to educate the women, and to provide this much desired service.

Awareness and Perception of Epidural Labor Analgesia Amongst Parturient in South Eastern Nigeria

“…Various studies done in Nigeria on the level of awareness of labor analgesia reported 15-64% [4,5,10,16,18,19]. This is similar to what was reported from some other developing countries [11][12][13]15].…”

“…Studies on the level of awareness, perception, attitude and use of epidural analgesia for labor pain relief show that awareness and utilization of epidural labor analgesia is still very low in developing countries [6,7,[10][11][12][13][14][15].…”

Attitude of obstetricians regarding labour analgesia and limitations in practising it

“…[16][17][18][19] Another study stated that their participants knowledge about labour analgesia was obtained from friends, relatives, media and literature rather than from obstetricians. 18 Antenatal education of the women is important to sensitize them about pain relief in labour as women in developing country like India are generally subdued and their ability to seek and gain information is limited. Studies have also shown the benefit of integrating the services of anaesthetists, obstetricians and midwives both in educating the antenatal women and in providing labour analgesia.…”

Motherhood Choices of women attending Antenatal Care in a Tertiary Level Hospital in the Niger Delta Region of Nigeria

“…Nevertheless, pain perception is subject to individual variations [19]. The large proportion of mothers not being sure whether they would demand labour analgesia might not be unrelated to the fact that many mothers in Africa are not even aware of the availability of such pain relief during child birth, unlike what is obtained in industrialized nations of the world [18,19,20]. A study in Uganda revealed that only 7% of women in that series had knowledge of obstetric anaesthesia, which mirrors the results of this study, where only 14.4% of mothers would demand obstetric anaesthesia [19].…”

“…Among the mothers who preferred vaginal delivery, 296 (67.6%) were not sure they would demand analgesia or anaesthesia to control labour pain, even though labour pain has been described by some authorities as extremely painful [18,19]. Nevertheless, pain perception is subject to individual variations [19].…”