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Labour pain is extreme pain experienced by women influenced by physiological and psychological processes of birth and extent to which women perceive pain.
Women with a fear of
childbirth antepartum requested pain relief more frequently as compared to
women without fear of childbirth antepartum, but this association was not
statistically significant.
Labour pain is
extreme pain experienced by women influenced by physiological and psychological
processes of birth and extent to which women perceive pain. The experience of
labour pain varies among women. The fear and anxiety associated with pregnancy
and childbirth lead to increased perception of pain. Due to the higher impact
of increased pain perception on both the mother and mother-infant interaction,
childbirth fear has gained growing attention.
Pharmacological
methods of pain relief have been widely used for treating labour pain. There
exist differences in the ways of pain relief and the percentage of women using
pain relief. Pharmacological pain relief methods reduce the pain experienced
during labour. However, childbirth satisfaction is also influenced by other
factors such as involvement of woman in decision making and the attitude of the
caregivers during labour.
The relatedness
between fear of childbirth antepartum and request for pain relief as well as
administering pharmacological pain relief and experienced childbirth
postpartum, have rarely been studied in a low-risk population. More knowledge
about this topic is required for counselling women for decisions regarding the
type of pain relief, use of pharmacological pain relief, and preferred a place
of birth
Rationale behind
research:
Previous studies
lack in providing robust data for evaluating the pain experiences of women who
receive and do not receive analgesia and their childbirth experience or
well-being, including fear of childbirth. Therefore, the present study was
intended to find the association between fear of childbirth antepartum and
request for pharmacological pain relief.
Objective:
The present
randomised controlled trial was conducted to evaluate the relatedness between
the fear of child antepartum and request of pharmacological pain relief. Also,
the association between the used pharmacological methods of pain relief and
experienced pain as reported postpartum was also evaluated.
Study outcomes:
Time Points: NA
Outcomes:
Baseline: There were no
significant differences observed at baseline
Study outcomes:
The results of the present study reported that the
frequency of fear of childbirth antepartum and fear of childbirth postpartum
were following the previous literature. Women with a fear of childbirth
antepartum were more likely to request pain relief during labour, but the
association was not statistical significance. It can be either due to lack of
power of study or due to the study population that consisted of low risk
labouring women under the care of a primary care midwife. It was also assumed
that women receive continuous support of labour during midwife-led care.
Previous research has reported that constant support of labour results in less
pharmacological pain relief. The present study also suggests that women who
received epidural analgesia more often reported fear of childbirth postpartum
as compared to women with pharmacological pain relief. Previous studies were unable
to distinguish between pain relief methods and only reported about epidural
analgesia. No studies have contributed to finding an association between
remifentanil-PCA and fear of childbirth. However, the present study suggests
that women who received remifentanil-PCA did not report more fear of childbirth
postpartum as compared to women who used epidural analgesia with continuous
infusion.
It was also determined that the childbirth experience is
more influenced by already existing antepartum fear of childbirth than by
complications during labour. Fear of childbirth is also associated with obstetric intervention/complications as well as with caesarean section as
a preferred mode of delivery. It makes it essential to distinguish fear of
childbirth antepartum. After determination of the above factors, women can
choose treatment of their fear of childbirth to preclude both obstetric
intervention/complications and fear of childbirth reported postpartum as well
as perinatal costs.
The present study findings might be helpful for clinicians
to evaluate the various factors associated with the fear of childbirth and
labour pain relief in women before and after childbirth. It can be aid women in
preventing both the obstetric
intervention/complications and fear of childbirth reported postpartum as well
as perinatal costs.
BMC Pregnancy and Childbirth (2018) 18:347
Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study
Logtenberg et al.
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