Health> Vol.5 No.9, September 2013

Pregnant women’s awareness and acceptance of epidural anesthesia and its influence on cesarean section rate control in China: A qualitative study

DownloadDownload as PDF (Size:63KB)  HTML    PP. 1455-1460  

ABSTRACT

Background: Epidural anesthesia, as an effective pain relief method, could be viewed as an attempt to encourage vaginal delivery and control cesarean section. Increased demand caused by psychosocial factors such as fear of childbirth and labor pain is supposed to be one predictable drive of high cesarean section rate in present China. Little qualitative information on women’s awareness and perceptions of epidural anesthesia was found, but conscious efforts should be focused on this part to help generate policy-making priority. Methods: This study was carried out under an exploratory descriptive design in Bao’an Maternity and Child Health Hospital. Those interested in participating would be invited to focus group discussion or individual interview according to a semi-structured open-ended guide after collecting the participants’ demographic characteristics. The thematic content analysis approach was used for data analysis. Results: Five major themes were identified: 1. the sources to gain information on epidural anesthesia; 2. clinical impact; 3. social impact on awareness; 4. association between epidural anesthesia and cesarean section; 5. attitudes and questions about the current service implementation. Discussions: The interplay between pregnancy knowledge, socio-economic conditions, social support, insurance policy environment, women’s judgment of health care quality influences the ways women acknowledge and utilize epidural anesthesia service. Conclusions: As maternal requested CS due to low pain tolerance emerges gradually, natural labor with epidural anesthesia is a more suitable childbirth option, which is also expected to function in reducing CS rate by service-providers and administrators in the health departments of China besides building up a pain-free labor environment.

Cite this paper

Chen, R. , Cheng, Y. and Li, J. (2013) Pregnant women’s awareness and acceptance of epidural anesthesia and its influence on cesarean section rate control in China: A qualitative study. Health, 5, 1455-1460. doi: 10.4236/health.2013.59198.

References

[1] Lurie, S. and Priscu, V. (1993) Update on epidural analgesia during labor and delivery. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 49, 147-153. doi:10.1016/0028-2243(93)90263-C
[2] Morishima, H.O. (2007) Labor analgesia in the US and Japan. Masui, 56, 1040-1043.
[3] Schneider, M.C. (2002) Analgesia during labour: From taboo to evidence-based medicine. Anaesthesist, 51, 959-972. doi:10.1007/s00101-002-0414-6
[4] Eriksen, L.M., Nohr, E.A. and Kjaergaard, H. (2011) Mode of Delivery after Epidural Analgesia in a Cohort of Low-Risk Nulliparas Birth, 38, 4. doi:10.1111/j.1523-536X.2011.00486.x
[5] Lieberman, E. (1999) No free lunch on labor day. The risks and benefits of epidural analgesia during labor. Journal of Nurse Midwifery, 44, 394-398. doi:10.1016/S0091-2182(99)00057-9
[6] Thorp, J.A. and Breedlove, G. (1996) Epidural analgesia in labor: An evaluation of risks and benefits. Birth, 23, 63-83. doi:10.1111/j.1523-536X.1996.tb00833.x
[7] Marucci, M., Cinnella, G., Perchiazzi, G., Brienza, N. and Fiore, T. (2007) Patient-requested neuraxial analgesia for labor. Anesthesiology, 106, 1035-1045. doi:10.1097/01.anes.0000265165.06760.c2
[8] Leighton, B.L. and Halpern, S.H. (2002) The effects of epidural analgesia on labor, maternal, and neonatal outcomes: A systematic review. American Journal of Obstetrics & Gynecology, 186, 69-77.
[9] Chestnut, D.H. (1997) Does epidural analgesia during labor affect the incidence of cesarean delivery? Regional Anesthesia, 22, 495-499.
[10] Hopkins, K. (2000) Are Brazilian women really choosing to deliver by cesarean? Social Science and Medicine, 50, 725-740. doi:10.1016/S0277-9536(99)00480-3
[11] Osis, M.J., Pa’dua, K.S., Duarte, G.A., Souza, T.R. and Faundes, A. (2001) The opinion of Brazilian women regarding vaginal labor and cesarean section. International Journal of Gynecology & Obstetrics, 75, S59-S66. doi:10.1016/S0020-7292(01)00518-5
[12] Okonkwo, N.S., Ojengbede, O.A., Morhason-Bello, I.O. and Adedokun, B.O. (2012) Maternal demand for cesarean section: Perception and willingness to request by Nigerian antenatal clients. International Journal of Women’s Health, 4, 141-148.
[13] Wang, W., Wen, R., Chen, L., Li, L. and Cheng, Y. (2011) The analysis on tendency and influential factors of Cesarean Section rate in 2002-2009 in Bao’an, Shenzhen. Chinese Maternity and Child Health, 14, 2103-2105.
[14] Lumbiganon, P., Laopaiboon, M., Gulmezoglu, A.M., Souza, J.P., Taneepanichskul, S. and Ruyan, P. (2010) Method of delivery and pregnancy outcomes in Asia: The WHO global survey on maternal and perinatal health 2007-08. Lancet, 375, 490-499. doi:10.1016/S0140-6736(09)61870-5
[15] Hill, Z., Tawiah-Agyemang, C., Manu, A., Okyere, E. and Kirkwood, B.R. (2010) Keeping newborns warm: Beliefs, practices and potential for behaviour change in rural Ghana. Tropical Medicine & International Health, 10, 1118-1124. doi:10.1111/j.1365-3156.2010.02593.x
[16] Furness, P.J., McSeveny, K., Arden, M.A., Garland, C., Dearden, A.M. and Soltani, H. (2011) Maternal obesity support services: A qualitative study of the perspectives of women and midwives. BMC Pregnancy and Childbirth, 11, 69. doi:10.1186/1471-2393-11-69
[17] Heslehurst, N., Moore, H., Rankin, J., Ells, L.J., Wilkinson, J.R. and Summberbell, C.D. (2011) How can maternity services be developed to effectively address maternal obesity? A qualitative study. Midwifery, 27, 170-177. doi:10.1016/j.midw.2010.01.007
[18] Chang, S., Kenney, N.J. and Chao, Y.Y. (2010) Transformation in self-identity amongst Taiwanese women in late pregnancy: A qualitative study. International Journal of Nursing Studies, 47, 60-66. doi:10.1016/j.ijnurstu.2009.06.007
[19] Schneider, Z. (2002) An Australian study of women’s experiences of their first pregnancy. Midwifery, 18, 238-249. doi:10.1054/midw.2002.0309
[20] Burnard, P., Gill, P., Stewart, K., Treasure, E. and Chadwick, B. (2008) Analysing and presenting qualitative data. British Dental Journal, 204, 429-432. doi:10.1038/sj.bdj.2008.292
[21] Burnard, P. (1991) A method of analyzing interview transcripts in qualitative research. Nurse Education Today, 11, 461-466. doi:10.1016/0260-6917(91)90009-Y
[22] Rosato, M., Mwansambo, C.W., Kazembe, P.N., Phiri, T., Soko, Q.S., Lewycka, S., Kunyenge, B.E., Vergnano, S., Osrin, D., Newell, M. and De L Costello, A.M. (2006) Women’s group’ perceptions of maternal health issues in rural Malawi. Lancet, 368, 1180-1188. doi:10.1016/S0140-6736(06)69475-0
[23] Murray, S.F. (2000) Relation between private health insurance and high rates of caesarean section in Chile: Qualitative and quantitative study. BMJ, 321, 1501-1505. doi:10.1136/bmj.321.7275.1501
[24] Yoshioka, T., Yeo, S. and Fetters, M.D. (2012) Experiences with epidural anesthesia of Japanese women who had childbirth in the United States. Journal of Anesthesia, 26, 326-333. doi:10.1007/s00540-012-1328-3
[25] To, W.K. (2007) A questionnaire survey on patients’ attitudes towards epidural analgesia in labour. Hong Kong Medical Journal, 13, 208-215.
[26] Schaffer, M.A. and Lia-Hoagberg, B. (1997) Effects of social support on prenatal care and health behaviors of low-income women. JOGNN, 26, 433-440. doi:10.1111/j.1552-6909.1997.tb02725.x
[27] Feng, X., Xu, L., Guo, Y. and Ronsmans, C. (2012) Factors influencing rising caesarean section rates in China between 1988 and 2008. Bulletin of the World Health Organization, 90, 30A-39A. doi:10.2471/BLT.11.090399

  
comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.