///2010 Abstract Details
2010 Abstract Details2019-08-03T15:49:10-05:00

Epidural Labor Analgesia Information Contained on Popular Websites

Abstract Number: 115
Abstract Type: Meta Analysis/Review of the Literature

Kevin M Franck MD1 ; Darwin C Viernes MD2; Ramana K Naidu MD3; Shih-Kai Liu MD4; Laurent A Bollag MD5; Ruth Landau MD6


More than 70% of women in the US benefit from neuraxial labor analgesia, however most still have strong pre-conceived biases and erroneous knowledge about hospital-based labor analgesia. The internet provides a significant portion of this knowledge as 66% of 2003 searches related to medical information. This number is escalating as estimated internet use has grown 100% per year during the 90s and has currently reached 1.7 billion worldwide. To better understand womens expectations and knowledge about epidural labor analgesia, we conducted a search to identify the most popular websites reporting on labor analgesia and evaluated their authorship, sources, publishing body, currency and content.


Using Facebook we first conducted a survey among nulliparous and parous women (n=12) asking If you were pregnant and wanted information on pain control, what words would you put in your search browser? The 5 most common responses (epidural, pain relief, child birth, pregnancy, labor) were then directly placed into a Google search browser (Nielsen Netratings #1 search browser with 50% of all activity). The top 3 websites per key word were investigated and their web traffic obtained by implementing Alexa. Each website was interrogated for origin and structural information. Epidural risks, benefits and placement timing were extracted. Intra-website links were additionally investigated.


7 websites were analyzed; in order of web traffic popularity these were About.com (#28), Babycenter.com (#389), American Pregnancy Association (#5,839), Pregnancy.org (#54,035), Childbirth.org (#64,130), Epidural FQA, (unranked), and Brigham & Womens Department of Obstetrics Anesthesia (unranked). Midwives or doulas authored 4 websites, 2 by undefined medical review board and 1 by OB anesthesia. Risks and benefits were deemed adequately provided in 4 websites (although 5/7 reported epidurals increase the CS risk, and 6/7 that epidurals prolong labor). 3 websites focused solely on risks (Table). The currency of websites ranged from 1998-2009.


The most visited websites describing epidural labor analgesia are not authored by anesthesiologists nor contain current, updated and accurate information. Our search demonstrated that internet content may have a significant bias against epidural analgesia and may perpetuate erroneous knowledge among expectant mothers (and non-medical providers).

1. Arch Intern Med 2005;165:2618-24

SOAP 2010