Survey of Current Practice of Labour Analgesia Among Obstetricians in Nigeria: Implications For Pain-free Labour Initiative.

Abstract

Background: Labour pain has been described as the worst possible pain known to mankind. It is more excruciating than cancer pain, phantom pain or toothache. Failure to relieve pain of any cause has been regarded as a violation of fundamental human rights. This study aimed to evaluate the current obstetrics analgesia practice among physicians in Nigeria, identify constraints to the practice and recommend solutions to improve the provision of such service to parturients. Materials and methods:This descriptive cross-sectional questionnaire-based study on the availability and practice of intra-partum analgesia services was conducted among practitioners at the Departments of Obstetrics and Gynecology of 3 tertiary health institutions located in 3 of the 6 geopolitical zones of Nigeria. Results:Of the 120 questionnaires distributed to the participants, 81 (67.5%) of the respondents returned completed questionnaires. The age range of the respondents was 25-44 years with a mean age of 30.8 and a male to female ratio (M: F) of 1.7: 1. Majority of the respondents, 76 (93.8%) believed that intra-partum analgesia was important, epidural analgesia was the most known method of intra-partum analgesia by 86.4% of the participants and epidural analgesia was the most preferred, 61.7% of respondents. Majority of respondents, 66 (81.5%), did not have an institutional policy or protocol on intra-partum analgesia. Doctors working in the same centre responded differently to the questions in the distributed questionnaires; and this is suggestive of lack of departmental harmonisation of clinical practice in the form of Standard Operating Protocol on intra-partum analgesia. Conclusion:Although there is a high level of knowledge of intrapartum analgesia among physicians, inconsistencies in its practice exist within and between tertiary hospitals in Nigeria. Notable absence of institutional policies on intra-partum analgesia at the practice facilities of the respondents was also observed. conducted in 3 of the 54 tertiary health facilities in Nigeria. Thus, a similar study can be carried out at secondary and primary healthcare centres in order to obtain a more comprehensive attitude and practice of intra-partum analgesia among physicians in Nigeria