A Cross-Sectional Survey of Labor Pain Control and Women’s Satisfaction

Abstract

Introduction: Pain experienced during labor is a symptom of contractile activity and is a physiological feature of the uterus that occurs at the appropriate stages of labor. For the majority of women, labor pain is the most severe pain they will ever experience, and therefore should be relieved. Objective: (1) To evaluate labor pain intensity before and after using non-pharmacological and pharmacological interventions; (2) to assess women’s satisfaction of labor pain management. Methods: A multicenter cross-sectional survey study was performed on 500 women who gave birth in different reference level hospitals (i.e., I, II, III). Pain intensity was assessed according the Numeric Rating Scale (range 0–10), whereas women’s satisfaction was measured with a 5 point Likert scale. Results: The use of both non-pharmacological (median 6.7 (5; 8) vs. 4.5 (3.3; 5.5)) and pharmacological methods (median 8 (7; 9) vs. 5 (3; 6)) resulted in a significant reduction in pain (p < 0.01). Water immersion and epidural anesthesia proved to be the most effective non-pharmacological and pharmacological methods, respectively. In hospitals of reference I, analgesic management was based primarily on the use of non-pharmacological techniques, less often mixed, i.e., non-pharmacological and pharmacological techniques (27.5%). On the other hand, in hospitals with higher referentiality, mixed methods were used more often (level II—65.8%; level III—81.2%). Pain intensity was significantly higher (p < 0.0001) in hospitals with reference level I (median 5 (4; 6)) than in the hospitals with reference level II (median 4.2 (3; 5)) or level III (median 4.2 (3.3; 5.4)). Epidural anesthesia was most often performed (60%) in the hospital of reference II. Women’s satisfaction (median 4 (3; 5)), inter alia, was associated with the effectiveness of applied methods. Conclusions: The study findings suggest that women giving birth in hospitals of higher referentiality have better control of labor pain due to access to pharmacological methods. Epidural anesthesia remains the gold standard for relieving labor pain. The choice of a specific method is determined by the degree of hospital and associated with the pain referentiality.

The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review

“…Epidural anesthesia (EA), as one of the most common methods of labor analgesia, has the advantages of strong analgesic effect, fixed analgesic plane, long duration, and easy control of drug dosage [ 5 , 6 ]. It can effectively relieve labor pain, and the effect is stronger than that of general opioid anesthesia [ 7 , 8 ]. However, studies [ 9 , 10 ] have found that EA can prolong the second stage of labor.…”

Safety in obstetric anesthesia requires more research and support

“…There are pharmacological and non-pharmacological options to treat pain during vaginal delivery (11)(12)(13). The list of nonpharmacological options is large with strategies such as breathing and relaxation techniques, applying heat or cold, water immersion (shower, bathtub), touch and massage, acupuncture, transcutaneous electrostimulation, music and aromatherapy.…”

Evaluating the Efficiency of Non-Pharmacological Pain Management Techniques During Labor and Delivery

“…[Citation: kakar, P.K., Anila, khan, A.G.M., Sindhu, S. ( 2023 hydrotherapy, massage, visualization, positioning, and aromatherapy (Czech et al, 2018). Each technique targets distinct aspects of pain perception and coping mechanisms to reduce pain intensity, enhance relaxation, and foster a sense of control and empowerment during labor (Jones et al, 2012;Smith et al, 2018). Multiple studies have examined the efficacy of nonpharmaceutical pain management techniques in enhancing childbirth experiences.…”

“…This evaluation should consider pain reduction, maternal satisfaction, neonatal health, and long-term consequences on post-partum recovery. Understanding the advantages and disadvantages of these techniques will assist healthcare providers, policymakers, and expectant mothers make informed decisions (Hu et al, 2021;Pietrzak et al, 2022). The objective of the research evaluating the efficacy of nonpharmacological pain managing modus operandi during labor and delivery is to fill several knowledge gaps.…”