///2014 Abstract Details
2014 Abstract Details2019-07-18T14:34:47-06:00

A Qualitative Survey of Women’s Experiences of Pain Management during First Labor and Delivery: Patient Centered Outcomes

Abstract Number: T-03
Abstract Type: Original Research

Kristen H Kjerulff M.A., Ph.D.1 ; Mary B McAlevy M.D.2; Sonia Vaida M.D.3

Background: Randomized clinical trials and observational studies of the outcomes of specific methods of labor pain management have primarily focused on the pain relief effectiveness of specific treatments. However, little research has investigated what matters to patients when considering their labor pain management choices. Methods: We conducted a qualitative survey of 226 women after first childbirth at hospitals in Pennsylvania. Participants were asked several open-ended questions, including “When you were thinking about your labor pain management choices, which outcomes for you and your baby did you consider to be most important?”, “How did you decide what pain management to use in labor?”, “Did you feel that you were adequately informed about your pain management choices and the potential harms and benefits of these choices?”, and “What would you have liked to have known more about?” Results: In response to the question “When you were thinking about your labor pain management choices, which outcomes for you and your baby did you consider to be most important?” the most common answer (31.1%) was “safety for the baby”, the second most common (27.5%) was “safety for me and the baby”, and the third most common (14.4%) was “pain relief”. In response to the question “How did you decide what pain management to use in labor?”, the most frequent answer was that she did not decide ahead of time but wanted to wait to see how painful labor would be (33.0%), the second most frequent answer (22.0%) was that she decided what pain management to use based on her childbirth education classes and other educational efforts and the third most frequent (19.3%) was that she decided ahead of time that she wanted an epidural. A close fourth most frequent (17.4%) was that she decided ahead of time that she wanted to deliver naturally. The majority of the women (82.4%) felt that they were adequately informed about their pain management options and often mentioned having met with an anesthesiologist at their hospital ahead of time. Nearly half of the women (49.3%) said there was nothing that they would have liked to have known more about and 12.1% reported that they would have like to have known more about possible side effects of the both epidural and non-epidural drugs for themselves or their baby. Conclusion: When thinking about labor pain management options, the outcome of most concern for nulliparous women was safety for the baby, followed by safety for themselves and the baby. While some women decided ahead of time that they definitely wanted an epidural, or definitely wanted to deliver naturally, the women in this study most commonly waited to decide in labor how to manage their pain, based on the severity of the pain. The majority of the women felt they had been adequately informed about their pain management options and often mentioned having met with an anesthesiologist during their pregnancy and having been well-informed by this meeting.

SOAP 2014