Obstetric analgesia for vaginal birth in contemporary obstetrics: a survey of the practice of obstetricians in Nigeria

Abstract

BackgroundContemporary obstetrics in sub-Saharan Africa is yet to meet the analgesic needs of most women during child birth for a satisfactory birth experience and expectedly, obstetricians have a major role to play in achieving this.MethodsThis was a questionnaire-based, cross-sectional study of 151 obstetricians and gynecologists that attended the 46th Annual General Meeting and Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) held in Abakaliki, southeast Nigeria in November, 2012. SOGON is the umbrella body that oversees the obstetric and gynecological practice in Nigeria. Data was collated and analyzed with Epi-info statistical software, and conclusions were drawn by means of simple percentages and inferential statistics using Odds Ratio, with P-value < 0.05 at 95% Confidence Interval (CI) taken to be statistically significant.ResultsOf the 151 participants, males predominated; 110 (72.9%) practiced in government-owned tertiary hospitals in urban locations. Only 74 (49%) offered obstetric analgesia. Among users, only 20 (13.3%) offered obstetric analgesia routinely to parturients, 44 (29.1%) sometimes and 10 (6.6%) on patients’ requests. The commonest analgesia was opioids (41.1%). Among non-users, the commonest reasons adduced were fear of respiratory distress (31.1%), cost (24.7%) and late presentation in labour (15.6%).ConclusionThe routine prescription and utilization of obstetric analgesia by obstetricians in Nigeria is still low. Obstetricians are encouraged to step up its use to make childbirth a more fulfilling experience for parturients.

Practice of Labour Pain Management Methods and Associated Factors among Skilled Attendants Working at General Hospitals in Tigray Region, North Ethiopia: Hospital Based Cross-Sectional Study Design

“…But this study finding is much lower as compared to other studies like obstetric analgesia utilization in Addis Ababa, Ethiopia (54.2%) [12], epidural obstetric analgesia use in France (75%), Sweden (71%), Bangladesh (58.5%) [5], Colombia (31.5%) and South Africa (49%) [9]. Even in Nigeria 49% of obstetricians offered obstetric analgesia of which the commonest analgesia was opioids (41.1%) (13). And 27% of mothers in Canada received the commonest (92.6%) IM Pentazocine Hydrochloride for labour pain relief [14].…”

Awareness and desirability of antenatal attendees about analgesia during childbirth in a university teaching hospital in southern Nigeria

“…1 The perception of labour pain by parturients is influenced by many factors. 2,3 These include parity, maternal age, culture, social status, ethnicity, maternal and fetal weight, foetal position, educational attainment and the presence of a companion in labour. 3,4 Besides the compassionate concerns, labour pain may result in physiological changes with maternal and foetal consequences.…”

“…2 Pain relief management during labour has undergone various advancements since 1847 when Simpson discovered that chloroform could help relieve labour pains. 1 Currently, many options exists from; nonpharmacological ones like breathing, posture and relaxation techniques, hypnosis, acupuncture and trans electric nerve stimulation (TENS) to pharmacological ones like opiods (pentazocine, pethidine, fentanyl, remifentanyl), inhalational agents (entonox) and regional methods (epidural).…”

Knowledge and willingness of prenatal women in Enugu Southeastern Nigeria to use in labour non-pharmacological pain reliefs

“…Among non-users, the commonest reasons adduced were fear of respiratory distress (31.1%), cost (24.7%) and late presentation in labour (15.6%). 17 However, reports from South-Eastern and South-Western Nigeria show that an appreciable number (18.3% to 52%) of parturients use some forms of non-pharmacological methods. 6,9,18,19 One wonders if the women's use of the non-pharmacological methods in labour was their preference or that of skilled birth attendants because of unpopular use of pharmacological methods.…”