Allophone immigrant women’s knowledge and perceptions of epidural analgesia for labour pain: a qualitative study

OBJECTIVES: To explore allophone immigrant women’s knowledge and perceptions of epidural analgesia for labour pain, in order to identify their information needs prior to the procedure. DESIGN: We conducted focus groups interviews with allophone women from five different linguistic immigrant communities, with the aid of professional interpreters. Thematic analysis of focus group transcripts was carried out by all authors. SETTING: Women were recruited at two non-profit associations offering French language and cultural integration training to non-French speaking immigrant women in Geneva. PARTICIPANTS: Forty women from 10 countries who spoke either Albanian, Arabic, Farsi/Dari, Tamil or Tigrigna took part in the five focus groups. Four participants were nulliparous, but all others had previous experience of labour and delivery, often in European countries. A single focus group was conducted for each of the five language groups. RESULTS: We identified five main themes: (1) Women’s partial knowledge of epidural analgesia procedures; (2) Strong fears of short-term and long-term negative consequences of epidural analgesia during childbirth; (3) Reliance on multiple sources of information regarding epidural analgesia for childbirth; (4) Presentation of salient narratives of labour pain to justify their attitudes toward epidural analgesia; and (5) Complex community positioning of pro-epidural women. CONCLUSIONS: Women in our study had partial knowledge of epidural analgesia for labour pain and held perceptions of a high risk-to-benefits ratio for this procedure. Diverse and sometimes conflicting information about epidural analgesia can interfere with women’s decisions regarding this treatment option for labour pain. Our study suggests that women need comprehensive but also tailored information in their own language to support their decision-making regarding epidural labour analgesia.