The impact of labour epidural analgesia on the childbirth expectation and experience at a tertiary care center in southern India.
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.


OBJECTIVE
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.


CONCLUSIONS
Maternal satisfaction with the process of childbirth is a complex dynamic that is not limited to the significant relief from pain provided by LEA.
DNB Student, Department of Obstetrics, Fernandez Hospital , Hyderabad, India .
Hitanshu
H
Bhatt
Head and Consultant, Department of Anesthesia and Critical Care Services, Fernandez Hospital , Hyderabad, India .
Sunil
S
Pandya
Consultant, Department of Fetal Medicine and Obstetric Ultrasound, Fernandez Hospital , Hyderabad, India .
Geeta
G
Kolar
Head, Department of Women and Child Health Research, Fernandez Hospital , Hyderabad, India .
Praveen Kumar
PK
Nirmalan
Childbirth; Delivery; Labour epidural analgesia; Maternal satisfaction; Pain relief