Women’s epidural decision‐making in labour: A Townsville perspective

Abstract

Despite being an efficacious method of pain relief in labour, 1 regional analgesia is used in approximately a third of Australian labours (36%), 2 compared to Canada and the USA (approximately 60%) 3,4 and the UK (approximately 15%). 5 Australian data suggest that a pre-labour intention to use pharmacological options 6 and prior positive experience 7 were associated with an increased epidural preference. Data from outside of Australia suggest that perception of pain, 8,9 personal and peer experience 10,11 and desire for a natural birth 12 may contribute to women's labour analgesia preferences. However, these factors are subject to cultural influences. Therefore, to provide effective counselling and support for women locally to make informed decisions, it would be beneficial

Awareness, Perceptions, and Desirability of Epidural Analgesia Among Pregnant Women in King Fahad University Hospital, Al Khobar

“…This could indicate that the population is becoming more educated toward EDA. A study in Townsville, Australia, showed that 44% of participants disagreed that they would never use EDA, while 56% were unsure about whether EDA helps with labor progression, and 63% agreed that they were worried about the possibility that it will affect their ability to walk and move around [8]. These results were similar to our study with a small difference in the percentages (Table 3).…”

A Descriptive Study of Maternal Choices for Labor Pain Relief

“…An augmented labor increases the desire for an epidural, as noted in other studies. 2,5,6,11 However, epidurals were used less by our study participants being induced than those having labors augmented, possibly because a labor induction does not necessarily correlate with a poorly progressing labor. There is no currently known way to ensure a spontaneous labor and birth for everyone, but more evidence-based research on how to encourage and facilitate a spontaneous labor is possible.…”

“…As in previous studies, spontaneous labor again emerged as a key determinant for the desired childbirth outcome of a healthy mother and baby with minimal intervention. 5,6,11 Regardless of the number of pain relief measures chosen, a large number of study participants indicated a desire for an unmedicated labor (n = 301; 58.8%), either listing an unmedicated labor alone or in conjunction with another choice. This illustrates the trend among a Overall rating attributed to the last method used, assuming it to be representative of all methods used.…”

“…Concerns about personal safety, desire for improved neonatal outcome, desire for control, and previous experiences with labor have all been mentioned as reasons for women to consider labor pain relief choices carefully. 6,10 To accomplish this, all those providing care to women in labor must strive to maintain a supportive and nonjudgmental approach to all methods of labor pain relief. One of the most interesting findings is the number of study participants who chose more than 1 method for the pain relief of labor, prenatally (n = 334; 65.2%) and during labor (n = 279; 54.45%).…”

“…Wide differences existing in the use of regional analgesia between Australia (36%), Canada, the United States (60%), and the United Kingdom (15%) also suggest there is more to a satisfying childbirth experience than pain management alone. 6 In an oft-quoted systematic review of the literature regarding women's satisfaction with childbirth, Hodnett 7 identified 4 primary factors determining maternal satisfaction, that is, personal expectations, amount of support from caregivers, the quality of the caregiver-patient relationship, and the patient's involvement in decision making. Support from caregivers during labor is correlated well with maternal satisfaction in other research studies.…”