Predicting women's intentions to use pain relief medication during childbirth using the Theory of Planned Behaviour and Self‐Efficacy Theory

Abstract

Women's use of pain relief strategies during childbirth can be predicted to an extent by their prior intentions to use the strategy, although how women arrive at their intentions is currently unclear. This study investigated whether antenatal beliefs about pharmacological and non‐pharmacological pain management strategies predicted women's intentions to use Entonox (NO₂&O₂), pethidine, and epidural analgesia during childbirth. A self‐selected sample of 100 women in the third trimester of pregnancy completed a questionnaire containing belief‐based measures of the attitude, subjective norm, and perceived behavioural control components of the Theory of Planned Behaviour (TPB) for each medication, and the Childbirth Self‐Efficacy Inventory. Pharmacological beliefs as assessed by the TPB significantly predicted intentions to use all three medications. Subjective norm independently predicted intentions to use all three medications. Attitude predicted intentions to use NO₂&O₂ and epidural analgesia and perceived behavioural control predicted intentions to use pethidine alone. Beliefs about non‐pharmacological pain management strategies as assessed by self‐efficacy theory did not significantly enhance the prediction of intentions to use any of the medications. The findings suggest that targeting pharmacological beliefs during antenatal education will impact most upon women's intentions to use analgesia during childbirth.

Keywords:

• childbirth
• theory of planned behaviour
• self‐efficacy theory
• analgesic

Acknowledgements

Thanks go to the North West Wales NHS Trust, the NHS staff, the women who took part and to Dr David Clark‐Carter for statistical advice. The first author carried out this research in part fulfilment of a Master of Science Degree in Health Psychology.