Perception of Painless Labor in Rural India

Abstract

ABSTRACTNatural labor is physiological process but is associated with intense, excruciating pain. Epidural analgesia was introduced four decades ago as a method for relieving pain.In developed countries, the focus is on the choice of methods and complications, while in developing countries, the agenda still revolves around awareness, acceptability and availability of labor analgesia.Availability and affordability of epidural analgesia to combat, it is a major hindrance behind its low popularity.1The patients do not demand for it and the obstetricians are not keen to routinely practise it for several reasons. In developing countries so many centers lack availability of epidural anesthesia for labor and patient load is so much that equipment are less.At our setup in spite of availability and very low cost of epidural analgesia very few people opted for it.That is why, this study has been done to find out their perception and opinion for low acceptance of epidural analgesia.Aims• To assess the level of awareness, knowledge and acceptance of antenatal women to labor analgesia.• To analyze the different hindrances to make it a routine practise in our institute for labor analgesia.Materials and methodsAfter institutional ethics committee approval, 1000 consecutive parturient, attending antenatal clinic of our hospital were included in this cross-sectional survey from August 2013 to August 2014. Those not willing to take the survey were excluded. They were interviewed and counseled using a questionnaire that determined their knowledge of and attitudes regarding labor analgesia. A questionnaire was prepared in English and was translated and explained to patients in their mother tongue.ResultsMajority of the participants (73%) fell in the age group of 21 to 25 years and 52.5% of them belonged to the rural area. Most of them (67%) had no idea about labor analgesia but 48% of the participants expressed their interest to learn about the technique and its advantages. Most of them were primigravida who showed interest. The confidence interval (CI) value of attitude toward labor analgesia was 13.5 and knowledge of labor analgesia is CI = 20.14.Level of acceptance of labor analgesia after full information was found to be significantly correlated with the level of education and socioeconomic status, fear of delivery complications, and fear of labor pains, and their eagerness to deliver without suffering from labor pains.ConclusionThis discrepancy in the level of awareness and acceptance concluded to the fact that child birth is still viewed as a physiological process which is to be managed with as little interference as possible, pain associate with it is well accepted as compulsory associated agony.Educational status does have a positive correlation with the acceptance of the methods for pain relief during childbirth.Considering the level of education in our population, dedicated childbirth educators could help in improving obstetric care, help in allowing women to make their own decisions regarding childbirth and also sensitize them to access analgesia.Lots of efforts from obstetricians will be required to make poor parturient believe that the process can be painless and this is one of their right. And we can conquer over this pain beyond the boundaries of rich, poor, literate and illiterate.How to cite this articleShrivastava D, Chaudhary P. Perception of Painless Labor in Rural India. J South Asian Feder Obst Gynae 2015;7(3):130-133.