Epidural Analgesia during Labor: Attitudes among Expectant Mothers and Their Care Providers

INTRODUCTION: Varying levels of knowledge and attitudes among parturients and physicians toward epidural analgesia result in its low utilization. We aimed to assess the knowledge, attitude, and practice of parturients, obstetricians, and anesthesiologists regarding epidural labor analgesia. METHODOLOGY: We surveyed obstetricians, anesthesiologists, and parturients availing care and later delivered at our hospital from July 1, 2017, to December 31, 2017. Knowledge, attitude, and practice regarding epidural analgesia were collected using a semi-structured predesigned questionnaire. Data were described as frequencies and analyzed for association between parity and various beliefs and attitudes using Chi-square or Fisher's exact test. RESULTS: About 33% of the parturients knew that delivery is possible without labor pains, but only 18% were satisfied with the procedure. Timely epidural anesthesia could not be availed by 83% of the parturients due to unavailability of service. Among the obstetricians, 64% preferred epidural analgesia and thought that epidural analgesia prolongs the duration of labor, and 55% thought that it would increase the incidence of lower uterine segment cesarean section (LUSCS). In our survey, 48% of all anesthesiologists thought that epidural analgesia would lead to an increase in the incidence of instrumental delivery, 52% required intravenous analgesics with epidural, and 63% thought that it would not increase the incidence of LUSCS. Fear of labor and delivery pain, knowledge status, unwillingness and demand for epidural analgesia, satisfaction level, and reasons for not undergoing the procedure were significantly associated with the gravid status. CONCLUSION: Wide gap between desire for labor analgesia and its availability exists. A collaborative approach between anesthesiologists and obstetricians is required to disseminate correct information regarding epidural analgesia.