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      Knowledge, Attitude and Practices of Labor Analgesia amongst healthcare workers and patients: a single center cross sectional study

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          Abstract

          Background and Objective:

          Childbirth ranks amongst the most painful experiences a woman has to endure. In developing countries issues related to awareness, acceptability and availability of analgesia exist. This study aims to assess the knowledge, attitude and practices for labor analgesia amongst healthcare workers and patients.

          Methods:

          We performed a cross-sectional study conducted at Shaikh Saeed Memorial Campus of The Indus Hospital (TIH), Karachi. The study was performed in November 2016. Two surveys were conducted for this study; one for healthcare workers with patient interaction and second on patients attending their first antenatal clinic. The participants were asked to complete a survey following consent.

          Results:

          A total of 71 healthcare workers and 1005 patients participated in the study. Among healthcare workers, 43.7% felt that pain relief should be administered, 14.1% believed analgesia had adverse effects on fetus and 11.3% reported increased risk of cesarean section. Results from patients showed 27.9% were aware of labor analgesia and when informed, 85.2% were willing to have labor analgesia. In 14.1% of patients, labor analgesia was unsupported as they stated being a mother meant to endure pain.

          Conclusion:

          There is a wide gap between knowledge and practice of labor analgesia. Healthcare workers have a role in educating women, to be advocates for labor analgesia and to educate patients timely for this service.

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          Most cited references12

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          Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia.

          (2007)
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            A survey of healthcare providers’ knowledge and attitudes regarding pain relief in labor for women in Ethiopia

            Background To explore healthcare providers’ knowledge and attitudes to the need for pain relief for women in labor. Methods A structured questionnaire (n = 200) distributed to healthcare providers working in the obstetric departments, including theatres, of three public hospitals in different settings (rural, peri-urban and urban) in Ethiopia. Descriptive analysis was performed using Excel 2013 and SPSS version 22 for associations. Results The response rate was 81.5% with 164 questionnaires completed. The majority, 79% of respondents, understood that women can feel moderate to severe pain in labor and 77% were of the opinion that labor pain should be relieved. However, common practices included only supportive measures such as breathing and relaxation exercises, back massage and support from family. The general attitude of healthcare providers is that labor is a natural process, women should be able to cope and that pain relief is not a priority for women in labor. More than half, 52% of healthcare providers had safety concerns with using pharmacological methods to relieve pain in labor. Conclusion The majority of healthcare providers understand that women suffer significant pain during labor. However, providing effective pain relief is currently not provided as part of routine intra-partum care in Ethiopia. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1237-4) contains supplementary material, which is available to authorized users.
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              Obstetric analgesia for vaginal birth in contemporary obstetrics: a survey of the practice of obstetricians in Nigeria

              Background Contemporary obstetrics in sub-Saharan Africa is yet to meet the analgesic needs of most women during child birth for a satisfactory birth experience and expectedly, obstetricians have a major role to play in achieving this. Methods This was a questionnaire-based, cross-sectional study of 151 obstetricians and gynecologists that attended the 46th Annual General Meeting and Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria (SOGON) held in Abakaliki, southeast Nigeria in November, 2012. SOGON is the umbrella body that oversees the obstetric and gynecological practice in Nigeria. Data was collated and analyzed with Epi-info statistical software, and conclusions were drawn by means of simple percentages and inferential statistics using Odds Ratio, with P-value < 0.05 at 95% Confidence Interval (CI) taken to be statistically significant. Results Of the 151 participants, males predominated; 110 (72.9%) practiced in government-owned tertiary hospitals in urban locations. Only 74 (49%) offered obstetric analgesia. Among users, only 20 (13.3%) offered obstetric analgesia routinely to parturients, 44 (29.1%) sometimes and 10 (6.6%) on patients’ requests. The commonest analgesia was opioids (41.1%). Among non-users, the commonest reasons adduced were fear of respiratory distress (31.1%), cost (24.7%) and late presentation in labour (15.6%). Conclusion The routine prescription and utilization of obstetric analgesia by obstetricians in Nigeria is still low. Obstetricians are encouraged to step up its use to make childbirth a more fulfilling experience for parturients.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                January 2020
                : 36
                : 1
                : S4-S8
                Affiliations
                [1 ]Dr. Maher Ali, MBBS. Specialist Anaesthesiologist, Department of Anaesthesia, Civil Hospital Badin, Indus Health Network, Badin, Pakistan
                [2 ]Dr. Syed Farjad Sultan, PhD. Consultant Anaesthetist Department of Anaesthesia, Surgical Intensive Care and Pain Management. Ruth KM Pfau, Civil Hospital Karachi, Karachi - Pakistan
                [3 ]Dr. Anil Kumar, MBBS. Specialist Anaesthesiologist, Department of Anaesthesia, Intensive care and Pain Medicine, Indus Hospital Research Centre, The Indus Hospital, Karachi, Pakistan
                [4 ]Nida Ghouri, Research Associate, Indus Hospital Research Centre, The Indus Hospital, Karachi, Pakistan
                Author notes
                Correspondence: Dr. Syed Farjad Sultan, PhD. Consultant Anaesthetist Department of Anaesthesia, Surgical Intensive Care and Pain Management. Ruth KM Pfau, Civil Hospital Karachi, Karachi - Pakistan. Email: sfarjads@ 123456gmail.com
                Article
                PJMS-36-S4
                10.12669/pjms.36.ICON-Suppl.1715
                6943109
                31933599
                156e72b2-89ad-41f1-b1ed-cc4e65a44786
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 September 2019
                : 07 November 2019
                Categories
                Original Article

                epidural,labor analgesia,obstetrics,regional anaesthesia

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