Neuraxial Analgesia in Pregnant Hispanic Women: An Assessment of Their Beliefs and Expectations

Figures & data

Table 1 Participant Demographics

Characteristics	(N = 20)
Age (years), mean, (SD)	28.3 (6.2)
Education Less than high school	7
High school	10
Some college	1
College graduate	1
Advanced degree	1
Country of origin Mexico	16
Guatemala*	2
Honduras	1
Dominican Republic	1
Time in USA (years)	0.5–20

Notes: *Two patients spoke dialects from Guatemala: One patient spoke 2 dialects in addition to Spanish, another patient spoke 1 dialect in addition to Spanish. All other patients spoke Spanish as their primary language.

Table 2 Individual Characteristics of Participants During Pre-Partum Interview

ID	Age	Country of	Time in USA	Education	G/P*	Gestational Age
	(Years)	Origin	(Years)			(Weeks, Days)
1	22	Mexico	20	High school	G4P2012	28w4d
2	26	Mexico	4	College	G3P1011	24w5d
3	28	Mexico	8	High school	G8P5024	37w5d
4	33	Mexico	12	High school	G3P2002	39w1d
5	39	Mexico	19	College	G5P4004	35w0d
6	27	Mexico	10	6th grade	G5P3013	27w1d
7	23	Mexico	2	6th grade	G1P0	35w5d
8	43	Mexico	3	Master’s	G3P0020	20w0d
9	24	Mexico	6	6th grade	G1P0	29w6d
10	29	Mexico	12	High school	G4P2012	38w0d
11	20	Mexico	4	High school	G1P0	37w0d
12	22	Guatemala**	4	8th grade	G2P0010	39w5d
13	26	Mexico	5	High school	G3P2002	36w1d
14	32	Mexico	0.5	6th grade	G2P1001	26w5d
15	32	Mexico	11	High school	G4P2012	36w1d
16	27	Dom. Republic	9	High school	G3P0020	29w0d
17	38	Guatemala**	2	2nd grade	G6P5005	39w0d
18	19	Honduras	4	High school	G2P1001	37w2d
19	27	Mexico	14	High school	G2P1001	28w6d
20	29	Mexico	14	6th grade	G2P1001	36w6d

Notes: **Both patients from Guatemala spoke dialects of Guatemalan origin in addition to speaking Spanish. *Term, preterm, abortion, living.

Box 1 Theme 1 – Normalcy of Childbirth Pain (Pain is Good)

“Well, the pain means you’re giving life to a human being, and after the pain you have your reward because you have your baby.” “Well, I’ve never felt it but I imagine pain is just part of the process and I was told by the women in my family that birth pain is part of giving life.” “I believe that pain is natural, it is part of the process, pain helps you to push when the contractions come so pain is good.” “Pain is nature’s way of making me feel how significant and important giving birth is.”

Box 2 Theme 2 – Availability and Role of Pain Medication

“This time I am not going to get the epidural, I worry about the side effects of the epidural that is why this time I do not want it placed. Ever since I had it placed my back hurts, especially when the weather is cold, and my back did not hurt before the epidural.” “I worry about the side effects of the epidural. Does it hurt my baby some people say that it makes the baby too sleepy I don’t know the side effects but I worry about the side effect I will ask the doctor if I really need it.” “In regards to the epidural-well, I am going to try not to have it placed, but I am going to tell them that in case I need it, especially if my baby is in trouble, then maybe I can have it placed, but I will ask the doctor.” “I don’t want the epidural but if the doctor tells me that I need it for some reason for the safety of my baby I will do it but I don’t want it unless I really need it”.

Box 3 Theme 3 – Naturalistic Strategies to Endure Pain

“As I did in the previous ones, relax and breathe. I already have experiences as this is the third one.” “Well pray, breathe, and endure the pain. It is best to wait until the baby is ready to start to push.” “Well just breathe and squeeze my husband’s hand and try to be calm.”

Box 4 Theme 4 – Fear of the Unknown/Childbirth Process

“Well I was afraid because I did not know exactly what was going to happen” “I was scared because I did not know how it was going to be, they asked me if I wanted a normal birth or cesarean, I was in labor for 1 day but in the end it was natural.” “I felt nervous because I did not know what it was going to be like, the clinic gave me information and the nurses and doctors told me what it was going to be. I felt more or less ready.”

Table 3 Patient Characteristics at the Time of Admission, During Labor, and Delivery

ID	Age (Yrs.) G/P	Gestational		Admission	Anesthesia	Time to	Mode of
		Age		Indication*	Type**	Anesthesia (Hrs.)	Delivery***
1	23	G4P3013	40w1d	SOL	None		SVD
2	26	G3P2012	39w5d	SOL	CSE	1:59	SVD
3	28	G8P5025	38w5d	SOL	Epidural	1:40	SVD
4	33	G3P3003	39w3d	SOL	None		SVD
5	40	G5P5005	38w2d	SOL	Epidural	4:20	SVD
6	27	G5P4014	38w4d	SOL	None		SVD
7	23	G1P1	38w1d	IOL: GTN	CSE	20:45	1° LTCS
8	43	G3P1021	39w1d	IOL	Epidural	5:20	1° LTCS
9	25	G1P1	37w1d	IOL: GTN	Epidural	13:25	SVD
10	29	G4P3013	39w2d	SOL	None		SVD
11	21	G1P1	39w0d	IOL: GTN	Epidural****	14:00	SVD
12	22	G2P1011	40w0d	SOL	None		SVD
13	26	G3P3003	40w5d	IOL	Epidural	5:45	SVD
14	32	G2P2002	38w6d	SOL	Epidural	1:00	SVD
15	33	G4P3013	39w3d	IOL	CSE	4:35	SVD
16	27	G3P1021	40w2d	SOL	CSE	3:00	Vac. Ass.
17	38	G6P6006	39w6d	SOL	Epidural	1:00	SVD
18	19	G2P2002	40w1d	SOL	Epidural	5:10	SVD
19	27	G2P2002	41w0d	SOL	Epidural	3:00	SVD
20	29	G2P2002	41w1d	IOL	None		SVD

Notes: *SOL=spontaneous onset of labor, IOL=induction of labor, IOL: GTN-induction of labor for gestational hypertension at term. **0=no anesthesia, CSE=combined spinal epidural. ***SVD=spontaneous vaginal delivery, Primary lower transverse cesarean section, vacuum assistance. ****Patient received Fentanyl 100 mcg x 2 as well.