Between pain and pleasure: Pregnant women′s knowledge and preferences for pain relief in labor, a pilot study from Zaria, Northern Nigeria

Abstract

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.

Knowledge, Awareness and Acceptance of Labor Analgesia among Antenatal Women in a Remote Island: A Questionnaire Based Study

“…Similar results indicating the major source of information being from their friends and relatives were found in earlier studies too [15,16]. In contrary, a study done in Northern Nigeria showed the majority of women have heard of pain relief mostly from their caregivers and during the current pregnancy [12]. The level of awareness was also high in the said study which could be attributed to increasing discussions on the topic during antenatal visits.…”

“…Such low levels of utilization may be partly due to lack of knowledge, however it was found that even a very high number of women still were ready to bear the pain in their upcoming labor. It is prevalent in low resource settings too [11,12]. However it was also noted that the desire to bear the labor pain was much lower in women with previous experience which indicates that labor is a big source of pain and anxiety.…”

Perceptions and Practice of Labor Pain-Relief Methods among Health Professionals Conducting Delivery in Minia Maternity Units in Egypt

“…For example, a study done in Nigeria showed that women were worried about side effects on their babies (20%) or on themselves (17%), whereas some concerns were related to extra fees (3%) [14]. In our study, although 91% of HPs agreed to give pain relief during labor if facilities were available, 80.8% of them had some concerns regarding its use.…”

The use of pain relief during labor among migrant obstetric populations

“…Studies conducted in Nigeria have demonstrated differences in the level of pain reported by parturients from different tribal groups and between “westernized” and non‐westernized individuals [12]. Other work conducted in Nigeria found that many parturients were unaware of their rights regarding pain relief, frequently did not receive pain relief despite requesting it, and were fearful of caregivers and perceived side effects [16]. However, Nigerian patients have been demonstrated to have a high uptake of analgesia when it is offered [17].…”