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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Pregnancy and Childbirth 1/2018

Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

Zeitschrift:
BMC Pregnancy and Childbirth > Ausgabe 1/2018
Autoren:
Sabine L. M. Logtenberg, Corine J. Verhoeven, Katrien Oude Rengerink, Anne-Marie Sluijs, Liv M. Freeman, François G. Schellevis, Ben Willem Mol
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12884-018-1986-8) contains supplementary material, which is available to authorized users.

Abstract

Background

Fear of childbirth may reduce the womens’ pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women.

Methods

Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire.

Results

Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8–4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5–8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7–4.3).

Conclusions

Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.

Trial registration

Netherlands Trial Register 3687; Register date: 5 Nov 2012.
Zusatzmaterial
Additional file 1: Frequencies of the variables obstetric interventions and complications of women who completed the W-DEQ postpartum. (DOCX 13 kb)
12884_2018_1986_MOESM1_ESM.docx
Additional file 2: Characteristics of women who completed the W-DEQ antepartum and who did request pharmacological pain relief versus who did not. (DOCX 38 kb)
12884_2018_1986_MOESM2_ESM.docx
Additional file 3: Univariable analyses: association between method of pain relief and fear of childbirth reported postpartum. (DOCX 36 kb)
12884_2018_1986_MOESM3_ESM.docx
Literatur
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