Patients' preferences for labor analgesic counseling: A qualitative analysis

Toledo, P.; Pumarino, J.; Grobman, W. A.; Wong, C. A.; Holl, J. L.; Hasnain-Wynia, R.

Birth. 2017 May 6; 44(4):345-351

Abstract

BACKGROUND: The decision to use, or not use, neuraxial labor analgesia is complex, with both maternal and fetal considerations. Fears and concerns about neuraxial analgesia may influence analgesic decision-making. Little is known about patients' preferences for analgesic counseling. Therefore, the objectives of this qualitative study were to evaluate the sources of information used by patients, the timing and content of antepartum counseling about labor analgesia, and patients' preferences for such counseling. METHODS: A semi-structured interview guide was developed. Survey domains included the sources of information used by patients, the timing and content of antenatal counseling, patients' perceptions of intrapartum analgesic counseling, and their preferences for analgesic counseling. Interviews occured on postpartum day 1. Interview transcripts were analyzed using content analysis. RESULTS: The interviews of 45 women were analyzed. The Internet was the most frequently mentioned source of information (44%). The majority of women (78%) discussed analgesic options with their obstetric providers before delivery. All women were counseled intrapartum by an anesthesiologist, but several women commented on the difficulty of concentrating while laboring. Seventy-three percent of women stated that they would want counseling on analgesic options from their obstetric provider during the second or third trimester. CONCLUSIONS: Women prefer to be counseled about labor analgesia by their obstetric providers, as they have an established relationship. Patients would prefer the counseling to occur during pregnancy, before the onset of labor. However, given the frequent use of the Internet, the content and quality of online materials should also be evaluated.

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