Knowledge and Attitudes towards Epidural Analgesia among Women of Childbearing Age in Jazan, Saudi Arabia: A Community-Based Cross-Sectional Study to Identify Predictors through Multivariate Modeling

Epidural analgesia (EA) is a central nerve blockade technique. It is linked to a significant reduction of labor pain and side effects. This study was designed to investigate the knowledge and attitudes towards EA among women of childbearing age (18–45 years) in Jazan, Saudi Arabia, and identify predictors through multivariate modeling. A random sampling technique (n = 680) was used for this cross-sectional, self-administered survey. A previously validated online questionnaire was distributed. After establishing a P value of less than 0.05 to denote statistical significance, SPSS was used to examine the data using descriptive analysis, the chi-square test of homogeneity, and multivariate logistic regression. Six hundred and eighty women were studied. Over 75% of the participants were university educated; less than half (46.3%) were 21–30 years old, students (42.2%), and had never been pregnant (49%). The previous mothers who had never had EA labor accounted for 64.6% (n = 347, 51.0%). “Family/friends” (39%), followed by “internet” (32%), were the most common sources of EA information. Those who correctly defined the EA accounted for 61.8%. Those who reported weak or no contractions after EA accounted for 32.2%. Those who said EA insertion hurt more than labor did accounted for 56.3%. Those women who said one should give consent to EA accounted for 83.1%. Those who believe EA is safe for the baby accounted for 50.1%. Those who knew about EA complications accounted for 24.34%. According to multivariate modeling, attitude score plays a significant role in determining the participant’s knowledge level. This study found that childbearing women know a little about EA. Attitudes affected this knowledge level, and demographics did not. Cognitive intervention is needed to change these attitudes and spread EA-related knowledge.

[1]  M. Ageel,et al.  Knowledge and Practice of and Attitude Toward Epidural Analgesia Among Pregnant Women in Jazan Region of Saudi Arabia , 2022, Cureus.

[2]  M. Hargraves,et al.  The Children , 2020, Bring Now the Angels.

[3]  W. Hassan,et al.  Knowledge, attitude, and practice of childbearing women toward epidural anesthesia during normal vaginal delivery in Alsanayeah Primary Health Care in Khamis Mushait , 2020, Journal of family medicine and primary care.

[4]  R. Onoh,et al.  Perceptions and practice of epidural analgesia among women attending antenatal clinic in FETHA , 2017, International journal of women's health.

[5]  R. Trevethan,et al.  Deconstructing and Assessing Knowledge and Awareness in Public Health Research , 2017, Front. Public Health.

[6]  N. ALSaleh,et al.  Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia , 2017, Electronic physician.

[7]  O. Kimberger,et al.  An observational study of the macro‐ and micro‐haemodynamic implications of epidural anaesthesia in children , 2017, Anaesthesia.

[8]  B. Kebede,et al.  A survey of healthcare providers’ knowledge and attitudes regarding pain relief in labor for women in Ethiopia , 2017, BMC Pregnancy and Childbirth.

[9]  D. Papoutsis,et al.  The Effect of Epidural Analgesia on the Delivery Outcome of Induced Labour: A Retrospective Case Series , 2016, Obstetrics and gynecology international.

[10]  S. Weisman,et al.  Migration of pediatric epidural catheters , 2015, Paediatric anaesthesia.

[11]  A. Sia,et al.  Modern neuraxial labour analgesia , 2015, Current opinion in anaesthesiology.

[12]  A. Samueloff,et al.  Epidural analgesia and severe perineal tears: a literature review and large cohort study , 2014, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[13]  A. Moriarty Pediatric epidural analgesia (PEA) , 2012, Paediatric anaesthesia.

[14]  Jun Zhang,et al.  Contemporary Patterns of Spontaneous Labor With Normal Neonatal Outcomes , 2010, Obstetrics and gynecology.

[15]  D. Cicarelli,et al.  Elevation of Uterine Basal Tone and Fetal Heart Rate Abnormalities After Labor Analgesia: A Randomized Controlled Trial , 2009, Obstetrics and gynecology.

[16]  D. Cabrol,et al.  Is epidural analgesia a risk factor for occiput posterior or transverse positions during labour? , 2005, European journal of obstetrics, gynecology, and reproductive biology.

[17]  E. Lieberman,et al.  Changes in Fetal Position During Labor and Their Association With Epidural Analgesia , 2005, Obstetrics and gynecology.

[18]  G. Afshan,et al.  Knowledge, attitude and practice of parturients regarding Epidural Analgesia for labour in a university hospital in Karachi. , 2005, JPMA. The Journal of the Pakistan Medical Association.

[19]  M. Krohn,et al.  Obstetric rectal injury: risk factors and the role of physician experience , 2004 .

[20]  Shiv k. Sharma,et al.  Labor Analgesia and Cesarean Delivery: An Individual Patient Meta-analysis of Nulliparous Women , 2004, Anesthesiology.

[21]  K. Rasmussen,et al.  [Long-memory of labor pain]. , 2002, Ugeskrift for laeger.

[22]  C. Howell,et al.  Randomised study of long term outcome after epidural versus non-epidural analgesia during labour , 2002, BMJ : British Medical Journal.

[23]  G. Capogna,et al.  Reducing likelihood of instrumental delivery with epidural anaesthesia , 2001, The Lancet.

[24]  E. Lieberman,et al.  Epidural analgesia and third- or fourth-degree lacerations in nulliparas. , 1999, Obstetrics and gynecology.

[25]  A. Hoeft,et al.  Practice of epidural analgesia for labour pain: a German survey. , 1999, European journal of anaesthesiology.

[26]  M. Walker Do Labor Medications Affect Breastfeeding? , 1997, Journal of human lactation : official journal of International Lactation Consultant Association.

[27]  Shiv k. Sharma,et al.  Randomized Trial of Epidural Versus Intravenous Analgesia During Labor , 1995, Obstetrics and gynecology.

[28]  A. Macas,et al.  Labor epidural analgesia and the incidence of instrumental assisted delivery. , 2015, Medicina.

[29]  H. Mohamed,et al.  Women’s Awareness and Attitude toward Epidural Analgesia , 2013 .

[30]  Kirti,et al.  Knowledge, attitude and acceptance of antenatal women toward labor analgesia and caesarean section in a medical college hospital in India , 2011, Journal of Obstetric Anaesthesia and Critical Care.

[31]  D. Chestnut Elevation of Uterine Basal Tone and Fetal Heart Rate Abnormalities After Labor Analgesia: A Randomized Controlled Trial , 2010 .