Awareness and desirability of labor epidural analgesia: a survey of Nigerian women

Background: Pain relief is an integral part of labor management. Epidural analgesia is the most effective form of pain relief, but in most Nigerian obstetric units it is not available. There is little information on the views of pregnant women about epidural analgesia during labor. Methods: A cross-sectional survey using a structured questionnaire was conducted in the antenatal clinic of University College Hospital, Ibadan, Nigeria to assess women's views about epidural analgesia. Results: Of the 650 women surveyed, 523 (80.5%) had knowledge of labour pain while only 127 women (19.5%) were aware of epidural analgesia. Knowledge was affected by parity. Awareness of epidural analgesia was related to occupational status (OR 11.00, 95% CI 5.31-22.83) and having previously experienced childbirth on one previous occasion (OR 1.75, 1.05-2.92). A total of 103 (15.8%) respondents wanted to receive epidural analgesia in their next labor. Occupation (P = 0.006), knowledge of epidural analgesia (P = 0.017) and previous use (P < 0.001) significantly influenced desire for epidural analgesia but only knowledge (OR 2.4 95% CI 1.4-4.3) and previous use (OR 5.3 95% CI 2.1-13.5) were of statistical significance on multivariate analysis. Conclusion: This study shows that the knowledge of labor epidural analgesia amongst Nigerian women is low. Despite limited availability, women who are aware of epidural analgesia and those who have received it in a previous labor were more likely to want it in their forthcoming labor. Some women may refuse its use despite their knowledge. © 2008 Elsevier Ltd. All rights reserved.