Ask an anaesthetist: informing parents about pain relief options in labour

Abstract

Background: Approximately 60% of women require anaesthetic intervention around the time of delivery of their baby.1 The National Institute for Health and Clinical Excellence and the Royal College of Anaesthetists both recommend that women should have access to information about analgesia and anaesthesia during labour.2 3 Often, the first time a mother meets an anaesthetist is during labour, when taking on new information and making informed decisions can be overwhelming. We aimed to elicit if there is a desire for further antenatal advice about analgesic options during labour, and if so, design a meeting to achieve this. Methods: We conducted a survey of postnatal mothers who had anaesthetic intervention during labour. Questions aimed to identify where they had received information about pain relief antenatally and whether they wished they had known more about the analgesic options available. The survey could be completed in 2 min and a QR code to link to the survey was provided to mothers during routine postnatal anaesthetic review. Results: The survey received 49 responses; 67% of respondents were primiparous. Midwives (n=36) were the commonest source of antenatal information regarding pain relief in labour, while anaesthetists were the source in just two cases. Some 22% of respondents agreed that they wished they had known more about pain relief options in labour, whereas 39% wanted to know more about the different types of anaesthetic that they might need. Some 49% of respondents were in favour of attending a group meeting antenatally to discuss pain relief during labour, with 63% being in favour of an online meeting. Based on the survey responses, we set up ‘Ask an Anaesthetist’—a service designed to enable parents to learn about the analgesic options in labour. The online session covered non-pharmacological, pharmacological, and regional options, and a question-and-answer feature was included. The sessions were advertised and delivered in collaboration with Health Matters, our Trust’s programme for public information and engagement, and the Maternity Voices Partnership, an NHS working group that works to develop local maternity care. Feedback was gained to enable improvement of future sessions. Conclusion: There is an appetite for further specialist advice antenatally about analgesic options during labour. An online session delivered by anaesthetists enables information to be given to expectant parents in an evidence-based and non-biased fashion. Collaboration with the Health Matters team and the local Maternity Voices Partnership group has enabled adequate reach to the target audience and ensures expectant mothers’ voices are heard. We plan to continue the delivery of these sessions to parents in the local area four times a year, developing the session as necessary based on feedback received. 1.NHS Digital. NHS Maternity Statistics – England 2021-22.National Institute for Health and Clinical Excellence. Antenatal Care. Clinical Guideline NG201, 20213.Royal College of Anaesthetists. Guidelines for the Provision of Anaesthetic Services. Chapter 9: Guidelines for the Provision of Anaesthetic Services for an Obstetric Population, 2023