Barriers and facilitators to birth without epidural in a tertiary obstetric referral center: Perspectives of health care professionals and patients

Knox, Alyssa; Rouleau, Geneviève; Semenic, Sonia; Khongkham, Malisa; Ciofani, Luisa

doi:10.1111/birt.12327

Cited by 7 publications

(30 citation statements)

References 43 publications

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“…Providing pain relief using effective analgesia like epidural is very important, considering that the process of childbirth is a life-changing event and the care which a pregnant woman receives during this important event may have a long-term emotional and psychological impact on her and this by extension may affect the health of the baby (16). This is consistent with the finding by Lim et al who reported that the extent of labor pain relief by epidural analgesia predicts lower postpartum depression scores (17). A parturient in labor should have a satisfying birthing experience that would make her look forward to her next pregnancy with enthusiasm.…”

Section: Discussionsupporting

confidence: 91%

“…Similar studies have also adduced comparable reason for poor utilization in some other similar settings (8,13). Knox et al identified several contextual factors which facilitated or were barriers to birth without epidural analgesia in tertiary health centers in Canada, with the following themes emerging from differing perceptions of pain, care providers ready for things to go wrong and insufficient resources (17).…”

Section: Discussionmentioning

confidence: 76%

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Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria

Anozie¹,

Lawani²,

Mamah³

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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Introduction Pain perception in labor is extremely variable among women depending on the parturient pain threshold and reaction to pain (1). For the majority of women, labor pain is considered severe and may be likened in severity to complex regional pain syndrome or amputation of a digit without anaesthesia (2). According to the American College of Obstetricians and Gynecologists and the American Society of Anaesthesiologists, there is no circumstance where it is acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under the care of a physician (2). The development of modern analgesia and in particular regional analgesia marked a major turning point in pain management during labor and delivery. Epidural analgesia is considered as the most effective method of pain relief and recommended as the first choice analgesia for women during labor and delivery (3,4). The level of awareness and practice of labor analgesia, particularly epidural analgesia in sub-Saharan Africa is still rudimentary and obstetricians undoubtedly have an important role to play in this regard. In 2012, a survey of the practice of labor analgesia a m o n g t h e obstetricians in Nigeria revealed that only 49% of the respondents offered analgesia to women in labor and of these, a paltry 2% used epidural analgesia (5). Pain management in labor is an important component of active management of labor and even though not all women request pain relief in labor, the obstetrician has a duty to discuss the options, benefits and risks associated with various methods of labor analgesia with the parturient irrespective of his or her belief (6, 7). Optimal pain control in labor is more likely to result in a satisfactory birth experience for the parturient and her care provider (8-12). A critical step in achieving this milestone is to survey the level of awareness of epidural analgesia, determinants and deterrents of its use among obstetricians practicing in Nigeria. Currently, there is no available literature documenting the utilization pattern, determinants and deterrents of epidural analgesia among obstetric care providers such as obstetricians in Nigeria. This study, therefore,

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 76%

Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria

Anozie¹,

Lawani²,

Mamah³

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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“…In labor and delivery, alleviating anxiety and stress in both mother and her companion is important to achieve an optimum outcome for both mother and baby. 7,5,17,18 In contrast to birthing, in end-of-life care, pain suppression is often prioritized over the need to alleviate anxiety and stress. 4,16,22 However, through similar practices used during childbirth, nurses in hospice care can help create a state of well-being in their patients diminishing their level of anxiety 19 and contributing to pain control.…”

Section: Anxiety and Stress Reductionmentioning

confidence: 99%

“…[5][6][7]18,20 Prenatal education is critical in enabling mothers to make informed choices. 7 When a woman feels in control and participates in the decision-making process, it increases her satisfaction with the childbirth experience. This leads to fewer medical interventions and improves outcomes for both mother and newborn.…”

Section: Self-care and Empowermentmentioning

confidence: 99%

“…When analyzing pain, similarities were found in the role of the nurse between childbirth and end-of-life. It is not possible for a nurse to help ease a patient's pain without clear communication; the patient must be included in the process 7,15. Nurses have to assess every aspect of the person before applying care and caring interventions 4.…”

Section: Caring During Birth and End-of-lifementioning

confidence: 99%

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The Good Life

Paff

Guillaumet

Zaragoza

et al. 2023

Holistic Nursing Practice

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Family centered nursing practices towards women and their families in the birthing context: A qualitative systematic review

2023

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AimSynthesize qualitative evidence examining how nurses' attitudes, beliefs, and sense of efficacy and the context surrounding birth facilitate or hinder family‐centered nursing practice.DesignThematic synthesis of qualitative studies.MethodsA literature search was conducted in CINAHL, MEDLINE, PsycINFO, SCOPUS, SCIENCE DIRECT, REPÈRES, CAIRN, and ÉRUDIT from October 2020 to June 2021. The PRISMA guidelines were followed, and studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted by two independent reviewers, and Thomas and Harden's qualitative thematic synthesis method was performed for data analysis.ResultsThirteen studies were included. Three analytical themes were generated: (1) sharing power: opposing beliefs, (2) feeling a sense of efficacy in fulfilling one's role, and (3) managing a challenging work environment.Patient or Public ContributionSynthesizing nurses' experience is essential to promote implementation of favourable changes for care that is more focused on the needs of families.

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Barriers and facilitators to birth without epidural in a tertiary obstetric referral center: Perspectives of health care professionals and patients

Cited by 7 publications

References 43 publications

Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria

Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria

The Good Life

Family centered nursing practices towards women and their families in the birthing context: A qualitative systematic review

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