Perceptions, practices and associated factors of midwifery care during labor with epidural analgesia
Article ID: JJAM-2024-0054
Details
Article ID: JJAM-2024-0054
Purpose
This study aimed to examine midwives' perceptions and practice situation of midwifery care during labor with epidural analgesia, along with the factors associated with these practices among midwives.
Methods
An anonymous, self-administered questionnaire survey was conducted among 927 midwives working in facilities offering labor with epidural analgesia. Exploratory factor analysis was used to assess perceptions of midwifery care during labor with epidural analgesia, and basic statistics were calculated to evaluate the status of care practices. Additionally, multiple logistic regression analysis was performed to identify factors associated with midwifery care practices in labor with epidural analgesia. Ethical approval for this study was obtained from the Ethical Review Committee of Yokohama City University (Approval No. General 2023-030).
Results
In total, 447 valid questionnaire survey responses were received (valid response rate: 98.8%). The following factors were identified as contributing to the perception of midwifery care during labor with epidural analgesia: “I have my own issues with midwifery care in labor with epidural analgesia,” “I want to learn more about and experience labor with epidural analgesia,” “I want to bring out the autonomy of pregnant women who choose labor with epidural analgesia,” “I feel the need for midwifery care from the pregnancy period during labor with epidural analgesia,” and “There are specific needs and support for labor with epidural analgesia.” Midwifery care for labor with epidural analgesia was implemented in over 80% of cases across 26 out of 31 identified care items, with particular emphasis on essential care during the delivery period. The factor most related to the practice of midwifery care for labor with epidural analgesia was the factor score of the fifth factor (OR: 1.84, 95% CI: 1.33-2.55).
Conclusion
The factor that most influences the practice of care labor with epidural analgesia is midwives' perception that “there are needs and support that are unique to labor with epidural analgesia,” In order to increase this awareness, it is necessary to deepen understanding of the unique needs of labor with epidural analgesia and to clarify the care related to these needs.
