///2010 Abstract Details
2010 Abstract Details2018-05-01T17:52:49+00:00

A survey to assess the Overall Experience of Labor and Delivery (OELD)

Abstract Number: 116
Abstract Type: Original Research

Ruth Landau MD1 ; Laurent A Bollag MD2; Philippe Richeb MD, PhD3; Brendan Carvalho MBBCh, FRCA, MDCH4; Lisa Y Flint BSc5; John C Kraft BSc6

Background

A majority of women in the US benefit from neuraxial labor analgesia; however when questioned most have strong pre-conceived ideas along with outdated knowledge about epidurals. Women who do not initially plan to deliver with an epidural are usually unsatisfied if they eventually request one. To better understand womens expectations, we conducted a survey of two academic institutions in California and Washington state. We hypothesized that women in Washington (W) would be less likely to want an epidural, and therefore would be more difficult to satisfy than women in California (C).

Methods

The birth experience was assessed using an Overall Experience of Labor and Delivery (OELD) survey instrument designed by a group of OB anesthesia specialists. The OELD survey included 17 demographic items and 10 questions related to a piori desire to deliver with an epidural and expectations of pain control, as well as a posteriori data. The survey was conducted over a 1-month period (July 2009). Women having scheduled CS and those unable to answer a questionnaire in either English or Spanish we excluded. Labor analgesia was not standardized (CSE or low dose epidurals were provided) to reflect the current practice in both institutions.

Results

210 (W) and 256 (C) consecutive women completed our survey within 24h after delivery (Table). Comparison between institutions showed fewer women in (W) wanted an epidural. In (C), pain scores were overall higher; more women reported that better pain control would have improved their OELD. In (W), OELD was similar in women delivering with and without an epidural and improving pain control would not have changed OELD.

Discussion

This survey confirmed that most women in (W) are more likely to be either undecided or not want an epidural. Despite differences in initial desire for an epidural, the ultimate epidural rate was similar. In both institutions, women received the targeted pain relief during 80% of the time; despite that, more women in (C) reported that better pain relief would have contributed to a better OELD.

Contrary to previous reports, in a cohort of women initially not in favor of epidurals, epidural analgesia proved to be satisfying and womens expectations seem to have been met. The OELD survey may be a useful instrument to provide insight into current practice and changes in case-mix and maternal attitudes to labor analgesia over time.

1. Reg Anesth Pain Med 2001;26:468-72



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