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Acceptability and Preferences for Labor Analgesia in Dominican Women
Abstract Number: T-26
Abstract Type: Original Research
Introduction: Barriers to labor analgesia programs in low resource settings include lack of financial resources, equipment or personnel; government or hospital policies; and patient education or cultural beliefs.1 In the US, Hispanic women are as likely to use labor analgesia as other ethnicities.2 Perceptions of labor analgesia may differ in women from the Dominican Republic (DR). We used a structured interview to evaluate women's perceptions of labor analgesia in one DR institution currently without a labor analgesia program.
Methods: Ethics board approval was obtained. Verbal consent was obtained. An anonymous structured, multiple choice and qualitative questionnaire was developed and interpreted in Spanish in collaboration with local physicians. The survey was self-administered with an interviewer available to clarify questions. All women 1-2 days postpartum were interviewed. A convenience sample of 2 weeks was used in an attempt to reach thematic saturation. Demographic data including age, gestation, parity and education level were obtained.
Results: We present preliminary data (1wk) from 24 women. 26 women were approached. 24 women completed the survey. The median age of women was 23 y (IQR 20-27). 12 women were nulliparous and 12 women were multiparous. The median maximum pain score was NRS 10 (IQR 9-10). The survey and results are presented in the Table. Most women desired labor analgesia that reduced but did not eliminate pain. Relaxation techniques were most preferred. The primary reason for not wanting analgesia was not believing in pain control during labor.
Discussion: The most common reasons US Latina women decline labor analgesia are acceptance of pain during labor, fear of back pain, and advice from family and friends.3 Our study population would accept labor analgesia, and although a procedure was not their preferred method for pain control, they would accept a procedure to lower their pain. The epidural labor analgesia services billed by the hospital is 4500 pesos, of which 15% is the out-of-pocket cost charged to publicly-insured patients. Of those who would be willing to pay for pain control, the cost of a labor epidural was within most women's stated budgets. Epidural labor analgesia would be an acceptable and affordable option for the DR women surveyed.
1. Kodali BS et al. Int J Obstet Anesth. 2014;23:267-73
2. Toledo P et al. Anesth Analg. 2012;114:172-8
3. Orejuela FJ et al. J Immigr Minor Health. 2012;14:287-91