Women who control pain relief in labour give themselves less drugs – study
Published 03/05/2011 | 09:11
Women in labour who control their own epidurals give themselves less pain relief, suggesting that doctors may be over-prescribing drugs.
A new study has found that women used 30pc less pain relief when they had the power over their drugs.
They were found to be as satisfied with their experience of labour as those who were given the standard pain relief.
However, they did admit to slightly more pain in the final stages of delivery as a result.
The findings were presented to the Society for Maternal-Foetal Medicine's (SMFM) annual meeting in San Francisco.
Dr Michael Haydon, a gynaecologist and obstetrician based in California, said the study showed that women gave themselves less pain relief and tended to give birth with less medical intervention.
Mothers-to-be whose choose epidurals often receive a continuous infusion of pain killer which can lead to a longer labour and an increased likelihood of an assisted delivery.
Dr Haydon said: “Several pain management studies have been done to begin looking at how much analgesia women use and what their pain experience is like when they are able to administer it themselves.
"We conducted the first double blind study, excluding inductions and including only women who were delivering for the first time, so that we could get a good sample of women with similar labour patterns.”
He observed women who were using Patient Controlled Epidural Analgesia (PCEA), who use a push button to deliver the drug into their systems via a catheter.
It takes between five and 10 minutes for the pain relief to take effect.
There is a 10 to 15 minute “lockout” period where the mother cannot give herself more of the drug, to ensure she does not receive too much.
However Dr Haydon said women were inclined to give less rather than more.
He went on: "The study concluded that PCEA resulted in 30pc less analgesia being used while maintaining high maternal satisfaction.
"Though patients in each group showed equal satisfaction, we did note that there was more pain during the final delivery stage in the PCEA group.
"The next step is to look at shortening the lock-out intervals between doses, or having the option of administering additional analgesia during the final pushing stage."
The study examined 270 pregnant women giving birth for the first time at California's Long Beach Memorial Medical Center randomly divided into three groups.
The first group received a standard epidural anaesthesia infusion which involves the insertion of a catheter into the epidural space of the spine.
Pain medication was then administered through the catheter by pump at a continuous rate throughout labour and delivery.
The second group was given the continuous epidural infusion, but was also given a button they could push to administer extra doses of medication every 20 minutes if desired.
The third group was not given the continuous infusion, but given only the button to receive doses every 20 minutes as desired.