Medication used in Denmark in the latent phase of labor - Do we know what we are doing?

Abstract

Objective: To describe the various combinations of medication used in Denmark in the latent phase of labor (i.e. for therapeutic rest) and to estimate the frequency of use.

Methods: An informal e-mail survey based on personal information from Danish midwives or staff obstetricians. The main outcome measures were type and dosage of medications used individually or in combination ("cocktail") for therapeutic rest in Danish delivery wards during the latent phase of labor and also the frequency of their use.

Results: All twenty-one delivery wards in Denmark participated in the survey. The types and dosages of medication varied substantially. Two delivery wards used prescriptions on morphine with no other medication for therapeutic rest. The remaining 19/21 delivery wards (90%) used a standard "cocktail" with two to four different types of medications; 19/21 wards (90%) used a mild analgesic (paracetamol), 17/21 (81%) used anxiolytics/hypnotics, and 14/21 (64%) wards used a strong analgesic (opioid) in their basic cocktail. Ten delivery wards (48%) combined an opioid, a sedative, and paracetamol in their basic cocktail. Between 7% and 21% of all pregnant women were given a cocktail.

Conclusion: In a small country, we found considerable national variation in the medication or combinations of medication used in the latent phase of labor, and polypharmacy was standard in the majority of the delivery wards.

Keywords: Labor pain; Latent labor phase; Morphine; Therapeutic rest.