Factors associated with choice of delivery with or without epidural analgesia among laboring women: a cross-sectional survey at a tertiary care hospital of a developing country.
OBJECTIVE
The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.


METHODS
In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.


RESULTS
From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.


CONCLUSIONS
Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.
Samina
S
Ismail
Shemila
S
Abbasi
Sobia
S
Khan
Abdul
A
Monem
Gauhar
G
Afshan
D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010154:Pakistan; D010353:Patient Education as Topic; D057240:Patient Preference / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D016312:Treatment Refusal / Q000706:statistics & numerical data