Background: Pain relief in labor remains a hot topic and these debates get louder by the day as more women become aware of their rights to better quality of care in labor. This study was conceived in a background where the practice of pain relief in labor is evolving and where women are seeking to fulfill their need for pain-free labor. Objective: To investigate the knowledge, utilization and preferences of methods of pain relief in labor by expectant mothers in order to design a labor analgesia program. Materials and Methods: A questionnaire-based descriptive study involving 124 antenatal clients in a teaching hospital over a 1 week period. Descriptive statistics were carried out using SPSS for windows version 17. Results: The mean age of clients was 28.8 years (standard deviation = 5.17) with median parity of two and mean gestational age was 31.5 weeks. Majority of the respondents (47.9%) were of Hausa/Fulani ethnicity and 97.6% had primary school level education. Majority (87.3%) had heard about pain relief methods with the hospital being the source in 79% of cases. The most common method ever heard about was epidural analgesia (69.4%). Only 4% (n = 5) of respondents remembered ever using any form of pain relief agent in labor, of which three received parenteral opioids. In their current pregnancies, 45.2% consented to the use of pain relief in labor; of which, epidural analgesia was preferred by 92.9% (n = 52). Fear of adverse effects on self and infants were cited as reasons for non-consent by some respondents while others had no reason. Conclusion: The study reveals a high awareness of pain relief methods which is not matched by utilization and low knowledge about side-effects, although fear of side-effects is a factor for under-utilization. There is a need to educate adequately as well provide high quality pain relief services in labor in order to dispel with myths, misconceptions and fears associated with the use of methods of pain relief in labor.
This study was carried out among women attending antenatal clinic in a tertiary health facility in northern Nigeria. Northern Nigeria is known for low levels of obstetric care utilization, high maternal mortality and low female education.[8] Majority of women deliver at home without the use of pain relief agents. Even the women that deliver within the health care facilities may have little or no access to labor pain relief information and services. The antenatal clinic used for this study is patronized by a diversity of clients, including the natives, mostly Hausa/Fulani women and settlers from other parts of Nigeria and beyond. With this client diversity, knowledge and choices for pain relief agents during labor could be diverse and information generated could be useful in designing a suitable labor analgesia protocol. The study was descriptive using a structured, pre-tested questionnaire in the English language consisting of socio-demographic questions and questions related to knowledge, preferences and utilization of most common pain relief agents available in the hospital. Antenatal care nurses were trained on the use of the questionnaire and administered it to the clients irrespective of their educational status. A total population survey was planned for the estimated 150 clients who utilize antenatal services weekly in the hospital. Each client was counseled about the study and served with the questionnaire after verbal consent was given. Consecutive clients were interviewed over a 1 week period in October 2011. Descriptive statistics were carried out on the data using SPSS for windows version 17 (SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc). Chi-square was use for the test as statistical significance, P < 0.05 was considered to be statistically significant.
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