Knowledge and Receptiveness of Epidural Labor Analgesia by Parturients at Two Teaching Hospitals in a Rwanda Analytical Cross-Sectional Study

Abstract

Background: Pain during labor and delivery can be severe and unbearable and differently perceived by parturient. Even with advances in medicine and awareness of labor analgesics, providing epidural for labor analgesia is still challenging due to a variety of factors including cultural pressure to experience normal labor, cost and of side effects. The aim was to evaluate the knowledge and receptiveness of parturient toward epidural for labor analgesia and also factors that affect receptiveness of labor analgesia. Methods: The study was analytical cross sectional and source of information was from the pregnant mothers attending antenatal care at university teaching hospital (CHUB and CHUK) during period of study of six months, from January 2022 to June 2022. Results: We recruited 388 participants with median age of 31 years. Thirty percent of the participants were aware of the existence of the epidural for labor analgesia and 33.61% of them knew the location of epidural labor analgesia. Fifty-five percent (55.61%) preferred epidural analgesia while 35.2% preferred intravenous labor analgesia. Women with university level were 6.5 times more likely to be aware of labor analgesia as those who attended at most the primary school (OR=6.52; 95% CI:2.45-17.36; P<0.001) Previous high pain intensity were 5.4 times more likely to be aware of the existence of labor analgesia as those who did not have pain (OR=5.38; 95% CI: 1.92-15.03; p=0.001). Primipara was 1.8 more likely to request the labor analgesia during the next labor as those who were multipara (OR= 1.82; 95% CI: 1.05-3.16; p=0.034); participants who expressed severe pain during the previous labor were 4.5 times more likely to have the desire to request the analgesia during the next labor as those who did not have pain (OR=4.52; 95% CI: 2.01-10.18; p<0.001) and participants who were in the Ubudehe third category were less likely to request the analgesia during their next labor as those who were in the first category of Ubudehe (OR=0.19; 95%CI: 0.40-0.97; p=0.047)

Conclusion: This study showed that knowledge and receptiveness of epidural labor analgesia was low. More education of parturients using different methods especially for low educational level can result to the improvement