Retrospective assessment of epidural analgesia during labor according to parturients

AIM: The aim of the study was to find out parturients' evaluation of epidural analgesia (EA) during labor and factors influencing their opinion. MATERIALS AND METHODS: 100 women, aged 26-42, who gave birth at I Department of Obstetrics and Gynaecology in Warsaw, filled in a specially prepared inquiry. Primiparas contributed to 87% of the study group. The results were analyzed according to analgesia evaluation as: very good (group A-64%), good (group B-30%) and insufficient (group C-6%). RESULTS: Patients evaluated their pain according to Visual Analog Scale before and after EA was applied in the I and II stage of labor, respectively. Significant differences regarding the pain level in the II stage were observed--among patients from group C it was even higher than before EA was applied. That group more often notified perineum pain during the II stage of labor. Feeling uterine contractions, tenesmus and drugs' side effects had no influence on women's opinion. The way of grading EA depended on parity and education--patients from group C were all well-educated primiparas. The time of making a decision about willing to give birth with EA also depended on parity--multiparas decided earlier than primiparas. Women's main source of information about labor EA were press and books (56%), than labor school (26%), other women (24%) and only for 20% their gynaecologist. In spite of the differences in their answers, the majority of women would decide on labor EA again (95%) and recommend it to others (98%). CONCLUSIONS: The majority of patients gives labor EA very positive opinion. Insufficient pain control in the II stage of labor and perineum pain are the main factors lowering EA evaluation--it seems important to pay more attention to that fact in the future. Time of making a decision about EA and women's opinion depend on parity. As press is the main source of information for patients, the wider promotion of EA by medical staff seems necessary.