Effectiveness of pain relief in labour: survey of 1000 mothers

Morgan, B.; Bulpitt, C. J.; Clifton, P; Lewis, P. J.

doi:10.1136/bmj.285.6343.689

Cited by 72 publications

(19 citation statements)

References 8 publications

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“…Of the remaining 278 women who answered the questionnaire, 134 (48%) were primiparas and 144 (52%) multiparas. The average age was 29 years (range 18-43) and education 13 years (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Almost all women were married or co-habiting (96%), and 88% were born in Sweden.…”

Section: Resultsmentioning

confidence: 99%

The complexity of labor pain: experiences of 278 women

Waldenström

Bergman²,

Vasell³

1996

Journal of Psychosomatic Obstetrics & Gynecology

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All women giving birth over a period of 2 weeks in a major city of Sweden, except non-Swedish speaking women and those with elective Caesarean sections, were asked about their experience of pain 2 days after the birth. The sensory (pain intensity) and effective (negative or positive experience) dimensions of pain, as well as need for pain relief during labor were explored. The 278 women who returned completed questionnaires (91%) reported high levels of pain, 41% worst imaginable pain, in spite of wide use of pharmacological pain relief. Only 9% had no analgesia. Pain was not an entirely negative experience, 28% assessing it as more positive than negative, suggesting that coping with pain is a rewarding experience for some women. More than 30 different explanatory variables were included in regression analysis to explain the variation in pain intensity and pain attitude scores, but only five contributed to the respective model. Most of the variables explaining pain intensity, namely anxiety during labor, expected pain, expected birth experience, midwife support and duration of labor, differed from the variables explaining attitude to pain. These were pain intensity, anxiety, expected birth experience physical well-being during pregnancy and emergency Caesarean section. The explanatory values were relatively low, especially for the model explaining pain intensity (R2 = 15%). The findings are discussed in the light of the different character and meaning of childbirth pain compared with pain related to disease.

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Section: Resultsmentioning

confidence: 99%

The complexity of labor pain: experiences of 278 women

Waldenström

Bergman²,

Vasell³

1996

Journal of Psychosomatic Obstetrics & Gynecology

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“…Similar to other studies, the present study has evidenced an association of this medical practice to women's socioeconomic status. 13 In the US, Hueston et al 9 (1994) also found higher administration of peridural anesthesia in white women who at the same time received more specialist care.…”

Section: Discussionmentioning

confidence: 98%

Desigualdades raciais, sociodemográficas e na assistência ao pré-natal e ao parto, 1999-2001

2005

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ObjectiveTo analyze social inequalities and inequalities in access to and utilization of health care services according to skin color in a representative sample of postpartum women receiving hospital childbirth care. Methods A cross-sectional study was carried out in a sample of 9,633 postpartum women, of whom 5,002 were white (51.9%), 2,796 mulatto (29.0%), and 1,835 black skin color (19.0%), seen in public maternity hospitals, hospitals contracted out by the Unified National Health System, and private hospitals in the period 1999-2001. Data were collected from medical records and through interviews with the mothers in the immediate postpartum period using standardized questionnaires. Statistical analyses were performed using χ² tests to assess homogeneity of proportions and Student's t-test for comparison of measures. The analysis was stratified by maternal schooling. Results A persistent unfavorable situation was seen for mulatto and black women as compared to white women. Mulatto and black women had the highest rates of adolescent mothers, low schooling, unpaid occupation, and not having a partner. History of physical violence, smoking, attempts to interrupt pregnancy, and visits to several hospitals before being admitted were more frequent among black women, followed by mulatto and then white women of low schooling. High schooling group of women showed better indicators but the same pattern was seen. This variability is also seen in the opposite direction in terms of the level of satisfaction with prenatal and childbirth care. Conclusions It was distinguished two forms of discrimination, by educational level and skin color, in care delivered by health services to postpartum women in Rio de Janeiro.

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“…Wuitchik et al (1990) showed that anxiety could persist even after adequate pain relief was achieved. Morgan et al (1977) concluded that, although analgesia was effective for pain relief, it could provoke anxiety and affect the birth experience.…”

Section: Maternal Anxiety and Painmentioning

confidence: 99%