Knowledge, attitudes and use of labour analgesia among women at a low-income country antenatal clinic

Knowledge, attitudes and intentions of the Syrian pregnant women toward labour analgesia, and its associated factors: a cross sectional study in Syria (2022)

BACKGROUND

During the reproductive period among pregnant women, the worst pain a woman can experience is labour pain. Untreated labour pain has many detrimental effects on the mother and the fetus. Then, the inadequate levels of awareness and attitudes toward labour analgesia among pregnant women are considered a serious concern that influences no-healthy results for both the mother and the baby. Therefore, this research aimed to define the degree of Awareness, Attitude, and intent to use labour analgesia among pregnant women in Syria.

METHODS

We conducted a cross-sectional study from 7 September to 23 October 2022, in which we included Pregnant Syrian women aged 18 and above. The questionnaire was based on a prior study that included verified and validated scales, which consisted of 23 questions separated into four sections. The sample size was calculated using Fisher's formula; however, our study included 638 participants. The data was analyzed using IBM SPSS Version 28.0, using descriptive and binary logistic regression methods.

RESULTS

Among those who had previous deliveries, 39.4% performed a caesarian delivery, and only 1.9% had a delivery at home. Nearly half of the study participants (50.4%) reported adequate knowledge about analgesia for obstetric pain. The inquired pregnant women who had children had more odds of knowledge than participants who had not. Respondents who were childbearing at the health center were more likely to have a good attitude (Adjusted Odds ratio = 4.728, P-value < 0.05, 95%CI: 1.035-21.589) than those who were childbearing at a national referral hospital. Also, the respondents above 31 years were less likely to desire labour analgesia than those aged 18-24.

CONCLUSION

Our results revealed that Syrian pregnant women have a moderated awareness, attitudes, and desire regarding labour analgesia, indicating a serious health problem among this population group. It is recommended that local and global health organizations address the current condition relevant to this issue by implementing healthy educational programmes for Syrian women through coordination with obstetric and gynaecological professionals.

Factors Affecting Women's Attitudes Toward the Use of Epidural Anesthesia During Labor in Riyadh in 2023

Background Epidural analgesia (EA) is a type of central nerve block achieved by injecting a local anesthetic near the pain-transmitting nerves. It is commonly used to relieve pain during labor. The intensity of pain experienced and the effectiveness of pain relief can affect a woman's labor and delivery experience. Labor pain is a long-lasting and debilitating pain that women experience; therefore, pain relief techniques have become widely available. However, not all women are willing to use EA for pain relief. The factors that influence women's choices regarding EA should be explored. This study aimed to comprehend women's perspectives on EA in Riyadh and clarify the variables influencing their decision-making. Methodology A total of 336 women in their reproductive years participated in this study. An online questionnaire with five sections was used to collect data. The socio-demographic information in the first section covered age, level of education, occupation, income, marital status, pregnancy, maternity, and prenatal care. The second section focused on how painful labor was for women who had already given birth. The third and fourth sections discussed labor pain relief techniques, including epidural anesthesia. The final section assessed the participant's interest in receiving EA during the next delivery. Socio-demographic data were considered to be a predictor, whereas awareness levels and a desire to receive EA were seen as results. The information was cleaned, coded, and entered into SPSS version 29 (IBM Corp., Armonk, NY, USA). The results are presented as frequencies and percentages. A Likert scale was used for data analysis. Statistical significance was established at p-values <0.05. Results In total, 336 Saudi women were included in this study, 86% of whom were between the ages of 30 and 35 years, and 69% of whom had a university education. One-third of the women (32%) had a monthly income of 10,000 to 20,000 SAR, and 55% of them had experienced three or more pregnancies. Fear of pain was the main reason for using epidural anesthesia in more than half of the participants given the choice. The most reinforcing factor was obtaining proper and sufficient information about EA, while the most restrictive factor was the fear of harming the infant. In particular, women aged 30-35 years (i.e., most of the included women) were commonly influenced by negative factors. Marital status and educational level played no significant role in women's use of EA. Conclusions Saudi women showed a good attitude toward EA. However, the awareness of EA was quite low. Fear of labor pain appeared to be the main reason for using EA. Health education programs on EA can increase the knowledge of and intent to use EA among women.

Women's Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor

This study aimed to assess knowledge about non-pharmacological pain-relief methods in labor among women who have given birth at least once. This cross-sectional study was conducted using an online survey among 466 adult women. The minimum sample size was estimated based on the number of labor admissions in the year before the study in Poland. The survey included questions about respondents' sociodemographics and knowledge of pain-relief methods. The knowledge score was calculated using the sum of correct answers. Non-parametric Spearman's correlation, Kruskal-Wallis and Wilcoxon variance tests were used. Antenatal classes (313/68.9%) and the Internet (248/54.6%) were the most common sources of knowledge. The most popular pharmacological pain-relief methods included epidural anesthesia (386/85.0%) and nitrous oxide (301/66.3%). Massage and breathing techniques were the most commonly known non-pharmacological methods (405/89.2% and 400/88.1%, respectively). The knowledge score about non-pharmacological methods was significantly higher as compared to the pharmacological methods score (r_c = 0.85; p < 0.001). Respondents' age correlated with knowledge about non-pharmacological methods (r_s = -0.10_,p = 0.026) but did not correlate with knowledge about pharmacological methods. Educational level correlated with knowledge about pharmacological (r_s = -0.13_,p = 0.007) and non-pharmacological (r_s = 0.14, p = 0.003) methods concerning pain relief in labor. No correlation was found between respondents' knowledge and gravidity, number of vaginal or cesarean deliveries, and hospital referral levels for previous deliveries. Our findings support the need to implement educational programs to increase evidence-based knowledge about pain-relief methods during labor in women.

Factors Affecting Opinion of Women Regarding the Use of Epidural Anesthesia During Labor in the Eastern Region of Saudi Arabia

Objectives Epidural anesthesia (EA) is one of the most popular and efficient techniques for labor pain relief. Women's preferences and awareness about EA have been investigated worldwide through various studies. The level of awareness varies from region to region in Saudi Arabia. Consequently, the aim of this study is to understand the views of women regarding EA in the eastern region of Saudi Arabia and how this affects decision-making with regard to EA. Methods This cross-sectional study was conducted in the eastern region of Saudi Arabia from July-September, 2021, through a self-administered online questionnaire. The study included Saudi females aged 18 years and older living in the eastern region of Saudi Arabia. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). A p-value less than 0.05 was considered statistically significant. Results A total of 499 participants were included in the study. Nearly half of them were between the age of 25-35 years (46.9%, n = 234). The mean of the awareness score was 3.66 with SD = 1.491. It was observed that age was related to awareness. Women older than 45 years of age were found to be less aware. Additionally, the number of children these women had further affected their awareness; those who had four children or more tended to be less aware. The effect of regular antenatal care visits was clear, as pregnant women who maintained regular antenatal care visits showed more awareness. As for income, there was a notable increase in awareness with an increase in income. Participants who had had a previous delivery with EA were found to be more aware. Likewise, educational status also impacted their awareness. Women with a high school certificate or below were found to be less aware. Lastly, it was observed that a majority of the participants chose not to request an EA upon their next delivery (60.5%, n = 302). Conclusion The results demonstrated that awareness of EA in the study area is acceptable. The most important predictors for awareness about EA were age, educational status, income, number of children, regular antenatal visits, and previous delivery with EA. It was concluded that women who were aware were more likely to take EA.

[Cultural myths on the use of analgesia in labor: A cross-sectional study in Nigerian women]

OBJECTIVE

Pain is termed as a subjective phenomenon, however almost all women acknowledge that labor pain is the most severe form of pain a woman experiences in her lifetime. Obstetric analgesia is underutilized in developing countries due to cultural myths and taboos. Hence, the present study aims to identify Nigerian women's knowledge of labor analgesia and to explore what myths and factors hinder with the use of analgesia in labor.

METHOD

A quantitative descriptive cross-sectional design was adopted in this study. The population of the study predominantly consisted of pregnant women from the «Yoruba ethnic group». An adapted semi-structured questionnaire was used to obtain data from participants from selected Health Care Centers in Ekiti state, Nigeria. The collected data was analyzed using a descriptive and inferential statistics and was represented in form of tables and charts with level of significance set at p ≤ 0.05.

RESULTS

A total of 236 respondents were included in the study (n = 236). Findings from this study revealed that, the participants showed very poor knowledge on labor pain management strategies, with only 26.3% being aware of pain management strategies used in relieving labor pain. An elevated number of the participants (56.8%) believed that labor pain should not be relieved with the use of drugs, strongly agreeing that analgesia was «a sign ofweakness» (57.2%). Also, more than half (51.7%) of participants had fears that pain relief administered during labor can cause harm to the unborn baby. Belief that experiencing labor pain completes one's motherhood (49.6%), Religion (50.4%) and Culture (54.5%), were reported as factors influencing the uptake/acceptance of labor analgesia among participants. Furthermore statistical significant association was found between educational level of participants and knowledge of labor analgesia among participants (p value = 0.000; p ≤ 0.05).

CONCLUSIONS

Cultural myths on the use of analgesia exist among participants. It is suggested that women-centered education should be targeted toward eliminating these myths and increasing awareness about labor analgesia.

Assessment of Awareness, Attitude and Desire for Labor Analgesia and Associated Factors Among Pregnant Women in Ethiopia: A Cross-Sectional Study

INTRODUCTION

Labor pain is the worst imaginable pain that women experience during their childbearing years. Untreated labor pain has numerous negative consequences, for both the mother and her fetus. Low levels of awareness and attitudes among pregnant women about labor analgesia is a major challenge that affects outcomes for both the mother and fetus. Therefore, this study aimed to assess the awareness of, attitude towards and desire for labor analgesia and its associated factors among pregnant women who visited an antenatal care facility.

METHODS

An institution-based, cross-sectional study was conducted from February to March 2019. Data were collected using semi-structured questionnaires by a convenience sampling technique. Data were entered using EpiData 4.2 and exported to SPSS version 20 software for analysis. Both bivariate and multivariate binary logistic regression analysis were used to identify factors associated with awareness, attitude and desire for labor analgesia among pregnant women. Crude odds ratio (COR) and adjusted odds ratio (AOR) were calculated to show the strength of association.

RESULTS

A total of 410 participants were included. Thirty-three (8%) of the pregnant women who visited the antenatal care facility were found to have an awareness of labor analgesia. In multivariate analysis, the likelihood of having awareness of labor analgesia was 7.227 times (AOR: 7.227, 95%, CI 2.406-21.720) greater among parous versus nulliparous mothers. The odds of having awareness of labor analgesia were 3.133 times (AOR: 3.133, 95%; CI 1.144-8.581) greater among government employees than among housewives. The odds of having a good attitude towards labor analgesia were 6.488 times (AOR: 6.488, 95% CI 1.894-22.227) higher in government employees than in farmers. Women in the age group of 25-31 years were 1.815 times more likely to want labor analgesia for their next delivery (AOR: 1.815, 95% CI 1.103-2.989).

CONCLUSIONS

The awareness of labor analgesia among pregnant women was low. There is a need for teamwork by all stakeholders in health sectors to improve attitudes and increase the desire for labor analgesia among pregnant women who visit antenatal care facilities.

Knowledge, Attitude and Practices of Labor Analgesia amongst healthcare workers and patients: a single center cross sectional study

Background and Objective:

Childbirth ranks amongst the most painful experiences a woman has to endure. In developing countries issues related to awareness, acceptability and availability of analgesia exist. This study aims to assess the knowledge, attitude and practices for labor analgesia amongst healthcare workers and patients.

Methods:

We performed a cross-sectional study conducted at Shaikh Saeed Memorial Campus of The Indus Hospital (TIH), Karachi. The study was performed in November 2016. Two surveys were conducted for this study; one for healthcare workers with patient interaction and second on patients attending their first antenatal clinic. The participants were asked to complete a survey following consent.

Results:

A total of 71 healthcare workers and 1005 patients participated in the study. Among healthcare workers, 43.7% felt that pain relief should be administered, 14.1% believed analgesia had adverse effects on fetus and 11.3% reported increased risk of cesarean section. Results from patients showed 27.9% were aware of labor analgesia and when informed, 85.2% were willing to have labor analgesia. In 14.1% of patients, labor analgesia was unsupported as they stated being a mother meant to endure pain.

Conclusion:

There is a wide gap between knowledge and practice of labor analgesia. Healthcare workers have a role in educating women, to be advocates for labor analgesia and to educate patients timely for this service.

Experiences with pain of early medical abortion: qualitative results from Nepal, South Africa, and Vietnam

Background

Medical abortion (MA) has become an increasingly popular choice for women even where surgical abortion services are available. Pain is often cited by women as one of the worst aspects of the MA experience, yet we know little about women’s experience with pain management during the process, particularly in low resource settings. The aim of this study is to better understand women’s experiences of pain with MA and strategies for improving quality of care.

Methods

This qualitative study was conducted as part of a three-arm randomized, controlled trial in Nepal, Vietnam, and South Africa to investigate the effect of prophylactic pain management on pain during MA through 63 days’ gestation. We purposively sampled seven parous and seven nulliparous women with a range of reported maximum pain levels from each country, totaling 42 participants. Thematic content analysis focused on MA pain experiences and management of pain compared to menstruation, labor, and previous abortions.

Results

MA is relatively less painful compared to giving birth and relatively more painful than menstruation, based on four factors: pain intensity, duration, associated symptoms and side effects, and response to pain medications. We identified four types of pain trajectories: minimal overall pain, brief intense pain, intermittent pain, and constant pain. Compared to previous abortion experiences, MA pain was less extreme (but sometimes longer in duration), more private, and less frightening. There were no distinct trends in pain trajectories by treatment group, parity, or country. Methods of coping with pain in MA and menstruation are similar in each respective country context, and use of analgesics was relatively uncommon. The majority of respondents reported that counseling about pain management before the abortion and support during the abortion process helped ease their pain and emotional stress.

Conclusions

Pain management during MA is increasingly essential to ensuring quality abortion care in light of the growing proportion of abortions completed with medication around the world. Incorporating a discussion about pain expectations and pain management strategies into pre-MA counseling and providing access to information and support during the MA process could improve the quality of care and experiences of MA patients.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12613000017729, registered January 8, 2013.

An evaluation of the different types of labor pain relief, preferred methods of pain relief, and effects of social media on awareness and knowledge among pregnant women. A cross-sectional study in the Kingdom of Saudi Arabia

Objectives:

To evaluate the attitudes of pregnant women towards different forms of labor pain relief, preferred methods of pain relief, and the effects of social media on their awareness and knowledge.

Methods:

This was a cross-sectional study conducted between April and August 2017 in the Maternity and Children’s Hospital, Najran, Saudi Arabia. A total of 416 pregnant women were interviewed and analyzed using IBM Statistical Package for Social Sciences version 20 (IBM Corp, Armonk, NY, USA).

Results:

A total of 62.7% were aware of labor pain. However, 58.7% of the total sample group was unaware of labor pain relief, and 79.8% of the total sample group was unaware of the different forms of labor pain relief available. Educational level was significantly associated with awareness and knowledge of labor pain relief (p=0.001). The majority of pregnant women obtained information from friends (57.5%); and only 16.1% of women received information from their health care providers.

Conclusion:

Most of the pregnant women recruited into this study had insufficient awareness of labor pain and methods of pain relief. They acquired their information from their friends and families rather than from their health care providers.

Perceptions of obstetric analgesia: a qualitative study among midwives attending normal vaginal deliveries in Durame Hospital, Southern Ethiopia

Background

Labor pain is distressing and produces undue side effects to both woman and fetus. In low-income countries like Ethiopia, addressing pain relief is often neglected. Professionals attending labor may not have awareness of obstetric analgesia. Besides this, there is a lack of published research on perceptions of obstetric analgesia among health professionals in Ethiopia. The aim of this study was to explore perceptions of obstetric analgesia among midwives attending normal vaginal deliveries in Durame Hospital.

Methods

The study adopted an exploratory descriptive qualitative approach in Durame General Hospital, Kembata Tembaro Zone, Southern Ethiopia from March 1 to April 2, 2017. Fifteen midwives were purposely selected and participated in in-depth interviews. Data from interviews were transcribed, translated to English, coded, and categorized into themes. Data analysis was initiated alongside data collection using a thematic approach. Written informed consent was obtained from all study participants.

Results

Scarcity of knowledge, negative attitudes, lack of trained personnel, and absence of protocols were impediments to using labor analgesia for midwives to relieve labor pain.

Conclusion

This study suggests that perceptions and practices of midwives with regard to labor analgesia needs special attention to address labor pain by scaling up forms and practice of labor analgesia in such a way that internationally accepted standards are met.

Women's experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review

BACKGROUND

Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women's views is important for good quality maternity care provision. We undertook a qualitative evidence synthesis of women's views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options, to understand what affects women's decisions and choices and to inform guidelines, policy, and practice.

METHODS

We searched seven electronic databases (MEDLINE, CINAHL, PsycINFO, AMED, EMBASE, Global Index Medicus, AJOL), tracked citations and checked references. We used thematic and meta-ethnographic techniques for analysis purposes, and GRADE-CERQual tool to assess confidence in review findings. We developed review findings for each method. We then re-analysed the review findings thematically to highlight similarities and differences in women's accounts of different pain relief methods.

RESULTS

From 11,782 hits, we screened full 58 papers. Twenty-four studies provided findings for the synthesis: epidural (n = 12), opioids (n = 3), relaxation (n = 8) and massage (n = 4) - all conducted in upper-middle and high-income countries (HMICs). Re-analysis of the review findings produced five key themes. 'Desires for pain relief' illuminates different reasons for using pharmacological or non-pharmacological pain relief. 'Impact on pain' describes varying levels of effectiveness of the methods used. 'Influence and experience of support' highlights women's positive or negative experiences of support from professionals and/or birth companions. 'Influence on focus and capabilities' illustrates that all pain relief methods can facilitate maternal control, but some found non-pharmacological techniques less effective than anticipated, and others reported complications associated with medication use. Finally, 'impact on wellbeing and health' reports that whilst some women were satisfied with their pain relief method, medication was associated with negative self-reprisals, whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes.

CONCLUSION

Women report mixed experiences of different pain relief methods. Pharmacological methods can reduce pain but have negative side-effects. Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters. Women need information on risks and benefits of all available pain relief methods.

Utilization of obstetric analgesia in labor pain management and associated factors among obstetric caregivers in public health facilities of Kembata Tembaro Zone, Southern Ethiopia

Background

Nowadays, obstetric analgesia is provided routinely in most developed countries. However, in developing countries, labor pain management is not a well-established service. The poor utilization of labor analgesia in low-income countries including Ethiopia results in laboring mothers in unmeasured suffering, let alone analgesia. The aim of this study was to assess utilization of obstetric analgesia in labor pain management and associated factors among obstetric caregivers in public health facilities of KTZ, Kembata Tembaro zone, Southern Ethiopia.

Materials and methods

A facility-based cross-sectional study design was conducted among all obstetric caregivers at KTZ in public health facilities from March to April 2017. Data were collected by a pretested, self-administered, and structured questionnaire. A convenient sampling technique was used and descriptive analysis was done to characterize the study population. Bivariate and multivariate logistic regressions were used to identify factors associated with utilization of labor analgesia. The adjusted odds ratio with 95% CI was used to show the strength of the association and a P-value <0.05 was used to declare the cutoff point in determining the level of significance.

Results

Three hundred forty respondents participated in the study with a response rate of 93%. The prevalence of labor analgesia use by the respondents was 37.9%. On multivariable logistic regression analyses, inadequate knowledge, positive attitude, and unavailability of labor analgesia drugs were significant independent predictors of obstetric analgesia utilization.

Conclusion

Proportion of analgesia utilization was low; inadequate knowledge, positive attitude, and unavailability of analgesia drugs in the facilities were significantly associated with obstetrics analgesia utilization. Health institutions and health personnel should work on provision of training for those obstetric care providers, and necessary drugs should be available in each facility.

"We know it's labour pain, so we don't do anything": healthcare provider's knowledge and attitudes regarding the provision of pain relief during labour and after childbirth

BACKGROUND

Most women experience pain during labour and after childbirth. There are various options, both pharmacological and non-pharmacological, available to help women cope with and relieve pain during labour and after childbirth. In low resource settings, women often do not have access to effective pain relief. Healthcare providers have a duty of care to support women and improve quality of care. We investigated the knowledge and attitudes of healthcare providers regarding the provision of pain relief options in a hospital in Moshi, Tanzania.

METHODS

Semi-structured key informant interviews (n = 24) and two focus group discussions (n = 10) were conducted with healthcare providers (n = 34) in Tanzania. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.

RESULTS

Most healthcare providers are aware of various approaches to pain management including both pharmacological and non-pharmacological options. Enabling factors included a desire to help, the common use of non-pharmacological methods during labour and the availability of pharmacological pain relief for women who have had a Caesarean section. Challenges included shortage of staff, lack of equipment, no access to nitrous oxide or epidural medication, and fears regarding the effect of opiates on the woman and/or baby. Half of all healthcare providers consider labour pain as 'natural' and necessary for birth and therefore do not routinely provide pharmacological pain relief. Suggested solutions to increase evidence-based pain management included: creating an enabling environment, providing education, improving the use of available methods (both pharmacological and non-pharmacological), emphasising the use of context-specific protocols and future research to understand how best to provide care that meets women's needs.

CONCLUSIONS

Many healthcare providers do not routinely offer pharmacological pain relief during labour and after childbirth, despite availability of some resources. Most healthcare providers are open to helping women and improving quality of pain management using an approach that respects women's culture and beliefs. Women are increasingly accessing care during labour and there is now a window of opportunity to adapt and amend available maternity care packages to include comprehensive provision for pain relief (both pharmacological and non-pharmacological) as an integral component of quality of care.

A survey of healthcare providers' knowledge and attitudes regarding pain relief in labor for women in Ethiopia

Background

To explore healthcare providers’ knowledge and attitudes to the need for pain relief for women in labor.

Methods

A structured questionnaire (n = 200) distributed to healthcare providers working in the obstetric departments, including theatres, of three public hospitals in different settings (rural, peri-urban and urban) in Ethiopia. Descriptive analysis was performed using Excel 2013 and SPSS version 22 for associations.

Results

The response rate was 81.5% with 164 questionnaires completed. The majority, 79% of respondents, understood that women can feel moderate to severe pain in labor and 77% were of the opinion that labor pain should be relieved. However, common practices included only supportive measures such as breathing and relaxation exercises, back massage and support from family. The general attitude of healthcare providers is that labor is a natural process, women should be able to cope and that pain relief is not a priority for women in labor. More than half, 52% of healthcare providers had safety concerns with using pharmacological methods to relieve pain in labor.

Conclusion

The majority of healthcare providers understand that women suffer significant pain during labor. However, providing effective pain relief is currently not provided as part of routine intra-partum care in Ethiopia.

Electronic supplementary material

The online version of this article (doi:10.1186/s12884-017-1237-4) contains supplementary material, which is available to authorized users.

Reported Pain During Labour - A Qualitative Study of Influencing Factors among Parturient During Confinement in Private or Government Hospital

INTRODUCTION

Labour pain is distressing and it produces undue side effects both to the mother and the baby. The incidence is high in developing countries like India where the awareness about labour analgesia is still lacking.

AIM

It is to find out the incidence of labour pain and the influence of various described factors on pain with a comparison between patients admitted in a government set up with a private set up in a south Indian semi-urban area.

MATERIALS AND METHODS

Two hundred continuous uneventful normal deliveries each in a Government (group G) and a private hospital (group P) were enrolled for the study. The reported pain during labour was noted 6-7 hours after delivery by interacting with the patient. The factors like age of the mother, sex and weight of the baby, literacy, socioeconomic status, the use of oxytocics and analgesia were evaluated.

RESULTS

The incidence of severe pain was more in group G (43.5%) than group P (12%). There was no analgesic intervention in 68.5% in group G while it was 13.5% (27/200) in group P. Even among these 27 patients who did not receive analgesics, only three parturients reported severe pain. Even administration of analgesics in a Government set up did not decrease pain to a significant extent. There were richer and more literate patients in group P. Booked cases were less in group G. Logistic regression analyses to find out factors which influenced pain in either group was used. Gravida, analgesic intervention and admission in a Govt. hospital influenced the pain experience of the parturient. There was minimal antenatal preparation in both the groups. There were no post partum complications.

CONCLUSION

Mothers suffered from labour pain to a significant extent and there is an urgent need for awareness about labour analgesia. Primigravida, admission in a Govt. set up and analgesic interventions were the factors which influenced pain than others. Patients admitted in Govt. hospitals suffered more pain with less analgesic intervention possibly due to illiteracy. The increased drug intervention in Group P was just incidental and routine on their demand and did not correlate with pain. A sincere effort to increase antenatal counseling should be initiated.