Abstract
BackgroundReceiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).MethodsThree focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).ResultsThe explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during a previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.ConclusionsThis study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.
Highlights
Receiving epidural analgesia during labor can possibly have negative consequences for mother and child
We considered the model fit to be excellent with a comparative fit index (CFI) ≥ 0.80, normed fit index (NFI) ≥ 0.80, Tucker-Lewis Index (TLI) ≥ 0.80, and root mean square error of approximation (RMSEA) ≤ 0.05 with an appropriate lower bound set at 0.04 [32, 33]
Two items of this subscale refer to beliefs a woman can have towards the outcome of receiving epidural analgesia (EA): the belief that she feels more self-confident during labor and performs much better with EA
Summary
Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Depression has been associated with expectations for negative outcomes in general [18, 19], which could imply that pregnant women with depressive symptoms may have worse labor pain expectations and could have greater willingness for request of pain relief medication during labor. Besides these personal factors influencing a woman’s decision to request for pain relief during labor, a woman’s attitude towards labor pain relief is influenced by cultural background, antenatal caregivers and social environment such as partner, family and friends [4, 9]
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