Identification of maternal characteristics associated with the use of epidural analgesia

Abstract

The present survey aims to identify predictors associated with the use of epidural analgesia (EA). Therefore, from October 2007 to June 2008, a survey was conducted in 193 pregnant women (mean age 31.7 years (SD 4.9); 64.8% primipara) attending a German general hospital with a specialisation in integrative medicine. Questionnaires, including Antonovsky's sense of coherence (SOC) were delivered antepartum. Delivery data were recorded within the hospital quality management programme. The adjusted odds ratio (OR) for EA use was significantly greater than one for women who had previously used EA (adjusted OR =4.1; CI: 1.03–16.31) and for the desire for a delivery without pain (adjusted OR =3.05; CI: 1.36–6.83). The likelihood of EA use decreased in multipara (adjusted OR =0.05; CI: 0.01–0.22). SOC was not found to be an independent predictor for EA use. However, women with high SOC more often preferred a delivery without EA (p for trend =0.037). In conclusion, first time labour, the desire for a delivery without pain and previous use of EA are independent predictors for the use of EA in labour. Further studies should clarify the predictive role of SOC in pregnancy.

Keywords::

• Epidural analgesia
• labour pain
• predictive factors
• salutogenesis
• sense of coherence

Acknowledgements

We would like to thank the team of midwives at the Gemeinschaftskrankenhaus Havelhoehe; Katie Renaud for editing the English version of this manuscript and finally, we would like to express our special gratitude to all participating women and their partners.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The survey was supported by grants from the Weleda AG.