Patient Education on Labor Analgesia Options

Completed

Conditions: Labor Analgesia

Registration Number: NCT02557555

Lead Sponsor: Rutgers, The State University of New Jersey

Brief Summary: The purpose of this study is to learn how the investigators can better educate pregnant patients about the options open to them for pain relief during labor. Patients will receive educational pamphlet during prenatal clinic visit and again on admission to labor and delivery. The options for analgesia will be discussed by anesthesia care provider. Patient will be asked to complete a survey on the post partum unit.

Detailed Description: Many analgesic options exist for laboring parturients, but labor may not be the best time to start informing patients of their options. Many patients begin the labor process with a plan in place for their analgesia. Unfortunately, internet resources regarding labor analgesia that are available to the lay parturient are poor and often lead to misconceptions about the options and their risks. A significant number of patients refuse neuraxial analgesia based on misunderstandings, concerns about the procedure, or a lack of faith in the provider. Some women want a "natural childbirth" and/or control over their labor experience. Our study aimed at providing information and alternatives for labor analgesia in a simple written format.

The investigators will provide information of available labor analgesia options (epidural, combined spinal/epidural, spinal, remifentanil patient-controlled analgesia, and intravenous opioids) to expecting mothers. Using a pamphlet written in English or Spanish disseminated to pregnant women in clinic and upon arrival in the labor and delivery unit, the procedures and their risks and benefits will be explained in simple terms. In the Labor and Delivery Unit the patients will have an opportunity to ask questions of the anesthesia care giver regarding the options for analgesia. After delivery while on F Green, patients will be asked to complete a questionnaire addressing their thoughts about the pamphlets and their overall satisfaction with their labor analgesia. The analysis will focus on the utility and effect of education materials on maternal informed consent for labor analgesia, on maternal choice of analgesia modality, and on maternal anxiety regarding their labor analgesia plan.

Recruitment & Eligibility

Status: COMPLETED

Sex: Female

Target Recruitment: 100

Inclusion Criteria

Postpartum women ages 18 and older
Patients who speak and read English or Spanish
Patients who received our informational pamphlet while pregnant or in labor
Patients who are able to consent and make medical decisions
Patients undergoing labor or trial of labor after cesarean delivery
Patients who undergo cesarean delivery after trial of labor

Exclusion Criteria

Patients unable or unwilling to complete questionnaire
Patients unable to consent or make medical decisions
Patients less than 18 years of age
Patients unable to read and speak English or Spanish
Patients in whom any of the analgesic options were contraindicated
Patients with a history of an anxiety disorder
Patients with precipitous labor or late presentation that precluded an analgesic intervention
Patients with fetal distress that precluded an analgesic intervention
Patients planned for elective cesarean section.

Study & Design

Study Type: OBSERVATIONAL

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Survey to Determine Utility and Effect of Educational Materials	expected average of no later than 48 hours following delivery	In order to assess the educational value of the pamphlet provided to parturients we evaluated all the questions pertaining education. There is no nominal value reported in units as all the data is merely described as the percentage of patients responding to educational questions. For example, 93% of patients (91/98) responded Yes to the question -Do you think the pamphlet you received did a better job explaining your options for control of labor pain than what you answered in the previous question \<patient research\>?

Secondary Outcome Measures