Intrapartum Analgesia-Have Women's Preferences Changed over the Last Decade?

Agnieszka Jodzis,Maciej Walędziak,Anna Różańska-Walędziak,Krzysztof Czajkowski

doi:10.3390/medicina58010087

Abstract

Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain relief. In total, 92.3% of women in 2010 and 94.9% in 2020 thought that they should have the possibility of independent choice of analgesia method before the delivery (p < 0.04). Conclusions: A high proportion of Polish women choose EDA over other pharmacological and nonpharmacological methods of pain relief in labor, and this preference has not changed over the last decade. Increasing women’s knowledge about different methods of intrapartum pain relief may lead to wider use of nonpharmacological methods of pain relief.

Highlights

The fear of labor pain is one of the main reasons for women’s preference for cesarean section (CS) over vaginal delivery, one of the most important factors responsible for the global increase in the proportion of cesarean deliveries
We found that there were no changes in the general proportion of women who wanted to have pain relief in labor, as well as in the proportion of those who wanted to have epidural analgesia (EDA), which was around 50% of the respondents both in 2010 and 2020
The number of women who were aware of the possible complications of intrapartum analgesia did not change either, nor did the proportion of those who wanted to choose the moment of administration of analgesia, which remained at the level of 40% at both time-points

Summary

Introduction

The fear of labor pain is one of the main reasons for women’s preference for cesarean section (CS) over vaginal delivery, one of the most important factors responsible for the global increase in the proportion of cesarean deliveries. Increasing women’s awareness of different possibilities of pain relief in labor may influence their choice of way of delivery. Global access to social media and high popularity of the subject of labor have changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. Depression and fear of childbirth increase the preference for EDA [8] Women discuss their preferences with their obstetricians and decide about the preferred method of labor analgesia many weeks before the expected date of delivery and prepare their birth plans, including pain management during labor [4]. Conclusions: A high proportion of Polish women choose EDA over other pharmacological and nonpharmacological methods of pain relief in labor, and this preference has not changed over the last decade. Increasing women’s knowledge about different methods of intrapartum pain relief may lead to wider use of nonpharmacological methods of pain relief

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