A questionnaire survey on patients' attitudes towards epidural analgesia in labour

William WK To; The Quality Assurance Subcommittee in Obstetrics and Gynaecology, Hospital Authority, Hong Kong
Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Hong Kong

OBJECTIVES. To evaluate patient attitudes about epidural services in labour and correlate them with patient options and actual usage of epidural analgesia.

DESIGN. Questionnaire survey.

SETTING. Eight Hospital Authority obstetrics units.

PARTICIPANTS. A cohort of new antenatal patients and a cohort of postnatal in-patients over 1 calendar month.

MAIN OUTCOME MEASURES. Antenatal patient awareness of epidural services and attitudes towards epidural analgesia during labour; the actual usage of such analgesia and the reported experience of postnatal patients.

RESULTS. A total of 2109 and 2851 patients completed the antenatal and postnatal survey, respectively. The former revealed that only 47% of patients had been exposed to the concept of epidural analgesia in labour, and only 13% opted for such analgesia. In the postnatal cohort, the overall epidural analgesia rate was 10%, although 19% had actually requested it. Patients who received epidural analgesia in labour were more likely to consider their experience as favourable (85%) compared to those who went through labour without such analgesia (26%) [P<0.001]. There was no significant improvement in knowledge about epidural analgesia among postnatal as compared to antenatal patients. The main reasons generally ascribed by patients for not being able to obtain an epidural service despite it being requested, were related to limited resources.

CONCLUSION. The results showed poor general awareness of pregnant women about the proper role of epidural analgesia in labour, leading to a low patient demand for such services. Despite the low prevailing request rate for epidural analgesia in labour, there appears to be a lack of adequate resources to meet the demand.

Hong Kong Med J 2007;13:208-15

Key words: Analgesia, epidural; Labor, obstetric; Patient satisfaction