Knowledge and decision-making for labour analgesia of Australian primiparous women

Midwifery. 2007 Jun;23(2):139-45. doi: 10.1016/j.midw.2006.06.004. Epub 2006 Oct 17.

Abstract

Objective: to assess and investigate knowledge of labour pain management options and decision-making among primiparous women.

Design: a semi-structured guide was used in focus groups to gather pregnant women's knowledge concerning labour analgesia. Attitudes to labour and pain relief, knowledge of pain relief, trustworthiness of knowledge sources, and plans and expectations for labour pain relief were investigated.

Setting: a major tertiary obstetric hospital in metropolitan Sydney, Australia.

Participants: twenty five primiparous women, who were 25 weeks or more gestation, and planning a vaginal birth.

Findings: although women considered themselves knowledgeable, they were unable to describe labour analgesic risks or benefits. There was a large discrepancy between perception and actual knowledge. The main source of knowledge was anecdotal information. Late in pregnancy was considered the ideal time to be given information about labour analgesia. Women described their labour pain relief plans as flexible in relation to their labour circumstances; however, most women wanted to take an active role in decision-making.

Key conclusions: the large discrepancy between perceived knowledge and actual knowledge of the likely consequences of labour analgesia suggests that women rely too heavily on anecdotal information.

Implications for practice: clinicians should be aware that some women overestimate their knowledge and understanding of analgesic options, which is often based on anecdotal information. Standardised labour analgesia information at an appropriate time in their pregnancy may benefit some women and assist health-care providers and women to practice shared decision-making.

MeSH terms

  • Adult
  • Analgesia, Obstetrical / nursing
  • Analgesia, Obstetrical / psychology*
  • Decision Making*
  • Delivery, Obstetric / nursing
  • Delivery, Obstetric / psychology*
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mothers* / education
  • Mothers* / psychology
  • Narration
  • New South Wales
  • Nurse-Patient Relations
  • Patient Acceptance of Health Care / psychology
  • Pregnancy
  • Risk Assessment
  • Surveys and Questionnaires