Original articles
The gap between expectations and realities of pain and fatigue in women receiving epidural anesthesia versus no anesthesia
2018 Volume 32 Issue 2 Pages 101-112
Details
2018 Volume 32 Issue 2 Pages 101-112
Objective
The objective of this study was to analyze the gap between expectations and experiences of pain and fatigue in childbirth, by comparing women's experiences with epidural anesthesia and those with no anesthesia, and to explore how the gap related to satisfaction with delivery.
Methods
This study was a longitudinal quantitative descriptive study using a questionnaire survey. Expectation of pain, actual pain, fatigue and satisfaction were measured quantitatively. It compared participants' responses at two-time points: during pregnancy after 36 weeks gestation and during postpartum (within 2 days). The survey was conducted with a purposive sample of 700 pregnant women from a Japanese urban hospital. The 609 (87.0%) valid responses were analyzed statistically.
Results
1. There was in gap between expectations and experiences of labor pain. Those who responded, “more painful than expected” were more frequently in the ‘no epidural anesthesia’ group. Conversely, those who responded that perineal pain was “more painful than expected” were more frequently in epidural anesthesia.
2. The fatigue after delivery was a mean of 60.1 (SD=27.2) with epidural anesthesia and a mean of 52.2 (SD=28.0) for no epidural anesthesia, which was significantly higher in the epidural anesthesia group (P<0.001). In both groups, those whose pain was higher than expected also had significantly higher fatigue levels.
3. Satisfaction with delivery was a mean of 7.61 (SD=1.85) with epidural anesthesia, a mean of 8.65 (SD=1.43) compared to no epidural, which was significantly higher (P<0.001). With epidural anesthesia, there was a significant inverse relation between ‘expectation and experience gaps’ of labor pain and satisfaction with delivery, but not with no epidural anesthesia.
Conclusion
This study confirmed there was a gap in women's (1) expectations of pain and actual experiences of pain and was related to (2) fatigue. In both groups, it is desired to reduce the gap between pain and fatigue.
This study highly recommends providing information to women during their antenatal care regarding pain management during labor and fatigue including the possibility of a gap in their expectations and experiences. In particular, for those women having epidural anesthesia, that gap between expectations of pain and actual labor pain had a greater influence on reducing satisfaction with delivery.
