The Influence of Education and Parity on Antenatal Women's Acceptance of Labor Analgesia

Background and Aim: Childbirth is one of the most desired, anticipated, and joyful experiences in women’s life. On the other hand, childbirth may be one of the most painful events experienced in a mother’s lifetime. Pain relief is nearly regarded as the right of patients in modern-day health care. Women undergo excruciating pain during normal vaginal delivery (NVD). However, the acceptance of labor analgesia (LA) has remained very poor. Labor pain relief remains a distant reality in developing countries. Many factors may affect the acceptance of LA.

Aim of the Study: The present study aimed to assess the correlation of previous exposure to such pain (parity) and school education with LA acceptance.

Methods: The present comparative study was conducted with a total of 400 consented participants. Consented women were enrolled in the study. A questionnaire was used to collect sociodemographic variables, acceptance/nonacceptance of LA, and the reasons for not opting for LA in upcoming delivery were noted. Participants were divided into primiparous, multiparous, and nulliparous (control). They were also grouped as per school education and compared taking illiterates as controls. Online open-source software was used which gave a sample of 70 in each group. Data are presented in absolute numbers. Fisher’s exact test is used for comparison; P < 0.05 was considered statistically significant.

Results: Effective analgesia during labor pain may contribute to better outcomes in high-risk expectant mothers. In this study, 17.5% multiparous and 38% primiparous participants were compared with 44.5% nulliparous women. Only 2.75% of participants were illiterate. Among all the participants, 69.50% were rural inhabitants and 81.50% believed in Hinduism. The finding shows that 87.14% multiparous, 84.21% primiparous, and 88.76% nulliparous women declined LA (P > 0.05). The desire to experience NVD without LA as a reason for nonacceptance was significantly less among primiparous and multiparous as compared to nulliparous (P < 0.0001), but not among literate and illiterate participants (P > 0.295 in all).

Conclusion: Previous labor pain significantly reduces the desire to experience NVD without LA, but still more than 80% parturient of any parity do not want LA due to one or more reasons. School education has no impact on LA acceptance. Ignorance, myths, and beliefs are also major contributors to the nonacceptance of LA.