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Van Leugenhaege L, Degraeve J, Jacquemyn Y, Mestdagh E, Kuipers YJ. Factors associated with the intention of pregnant women to give birth with epidural analgesia: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:598. [PMID: 37608256 PMCID: PMC10463581 DOI: 10.1186/s12884-023-05887-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND In Belgium most women receive epidural analgesia during labour. Although, it offers satisfactory pain relief during labour, the risk on a series of adverse advents has been reported. The objective of this study was to determine factors associated with the intention of pregnant women, anticipating a vaginal birth, of requesting epidural analgesia during labour. METHODS A cross-sectional study, using an online self-report questionnaire was performed, including socio-demographic and personal details. Associated factors were examined with the HEXACO-60 questionnaire, the Mental Health Inventory-5, the Tilburg Pregnancy Distress Scale and the Labour Pain Relief Attitude Questionnaire for pregnant women. The level of intention to request epidural analgesia was based on two questions: Do you intend to ask for epidural analgesia (1) at the start of your labour; (2) at some point during labour? Data were collected predominantly during the second and third trimester of pregnancy. Descriptive analysis and a multiple linear regression analysis were performed. RESULTS 949 nulliparous (45.9%) and multiparous (54.1%) pregnant women, living in Flanders (Dutch-speaking part of Belgium) anticipating a vaginal birth completed the questionnaires. Birth-related anxiety (ß 0.096, p < 0.001), the attitude that because of the impact of pregnancy on the body, asking for pain relief is normal (ß 0.397, p < 0.001) and feeling more self-confident during labour when having pain relief (ß 0.034, p < 0.001) show a significant positive relationship with the intention for intrapartum epidural analgesia. The length of the gestational period (ß - 0.056, p 0.015), having a midwife as the primary care giver during pregnancy (ß - 0.048, p 0.044), and considering the partner in decision-making about pain relief (ß - 0.112, p < 0.001) show a significant negative relationship with the intention level of epidural analgesia. The explained variability by the multiple regression model is 54%. CONCLUSIONS A discussion during pregnancy about the underlying reason for epidural analgesia allows maternity care providers and partners to support women with pain management that is in line with women's preferences. Because women's intentions vary during the gestational period, pain relief should be an issue of conversation throughout pregnancy.
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Affiliation(s)
- Luka Van Leugenhaege
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences and Arts Antwerp, Noorderplaats 2, 2000, Antwerp, Belgium.
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Julie Degraeve
- Department of Obstetrics and Gynecology, University Hospital Antwerp UZA, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics and Gynecology, University Hospital Antwerp UZA, Drie Eikenstraat 655, 2650, Edegem, Belgium
- University of Antwerp, ASTARC and Global Health Institute GHI, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Eveline Mestdagh
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences and Arts Antwerp, Noorderplaats 2, 2000, Antwerp, Belgium
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Yvonne J Kuipers
- Department of Health and Life Science, School of Midwifery, AP University of Applied Sciences and Arts Antwerp, Noorderplaats 2, 2000, Antwerp, Belgium
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, Scotland
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Kuipers Y, Degraeve J, Bosmans V, Thaels E, Mestdagh E. Midwifery-led care: A single mixed-methods synthesis. International Journal of Healthcare Management 2022. [DOI: 10.1080/20479700.2022.2070824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yvonne Kuipers
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Antwerp University, Wilrijk, Belgium
| | - Julie Degraeve
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Antwerp University, Wilrijk, Belgium
| | - Valerie Bosmans
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
| | - Ellen Thaels
- Faculty of Health & Wellbeing, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Eveline Mestdagh
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Antwerp, Belgium
- Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Antwerp University, Wilrijk, Belgium
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