Association of epidural analgesia with childbirth satisfaction among women with severe fear of childbirth: A cross-sectional study

Abstract

The relationship between fear severity and satisfaction after vaginal delivery was examined with a focus on its association with epidural analgesia. Postpartum cross-sectional questionnaire survey was conducted among 201 healthy women after vaginal delivery in Japan. The participants completed the Japanese Wijma Delivery Experience Questionnaire (JW-DEQ) Version B and the short version of the Childbirth Experience Self-Rating Scale, and were grouped by use of epidural analgesia and/or fear severity. Data were analyzed using Spearman correlation, Mann–Whitney U, and chi-square tests. No significant association between fear and satisfaction was found in the women without epidural analgesia. The proportion of women with severe fear of childbirth, defined as a JW-DEQ Version B score ≥ 85, was 39%. In the postpartum-recalled severe fear group, epidural analgesia was associated not only with higher overall satisfaction but also higher scores in its sub-factors: "labor pain coping" and "trust in medical staff". In contrast, epidural analgesia was associated only with "labor pain coping" score in the light fear group. Epidural analgesia induced higher childbirth satisfaction among women with severe fear. Although this study is limited by its cross-sectional design, potential recall bias, and the focus on a specific patient population, which may affect the generalizability of the findings, the factors of "labor pain coping" and "trust in medical staff " seem to be important to avoid fear of childbirth for giving childbirth satisfaction.