Experience of Back Pain Symptoms and the Choice of Epidural Analgesia in Labour: a Patient Questionnaire Survey

Abstract

Objective: To evaluate whether the experience of back pain affects patients’ preference for epidural analgesia in labour.
Methods: Two parallel cross-sectional surveys were performed in a cohort of antenatal patients and a cohort of postnatal patients over one month in an unselected general obstetric population. Two specific but parallel self-administered questionnaires were used separately for antenatal and postnatal patients. Questions were targeted on patients’ experience of back pain before or during pregnancy, and the impact of this pain experience on their attitudes towards using epidural analgesia in labour.
Results: A total of 261 antenatal and 365 postnatal patients were recruited. The incidence of back pain in antenatal patients was 8.4% and that in postnatal patients was 53.9%. Antenatal patients with back pain were less likely to request epidural analgesia when in labour (p<0.025), and were more concerned with postpartum back pain (p<0.05) as a possible complication. Postnatal patients with back pain were less likely to regard epidural analgesia as the most effective method of pain control in labour (p<0.05), and were less likely to request an epidural analgesia (p<0.05). They were more concerned with immobility and postpartum back pain rather than side-effects of epidural analgesia to the foetus (p<0.025) as compared to those with no pain.

Conclusion: The experience of back pain in the index pregnancy has a significant negative impact on patients’ attitudes and utilisation of epidural analgesia in labour.