• S Kannan, R N Jamison, and S Datta.
• Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. skannan@bics.bwh.harvard.edu
• Reg Anesth Pain Med. 2001 Sep 1;26(5):468-72.

Background And ObjectivesMany women who choose natural childbirth for labor ultimately request epidural analgesia to control labor pain. Unfortunately, parturients and family members may often be unprepared for epidural anesthesia, which can contribute to disappointment and dissatisfaction with their labor and delivery. This study examines how epidural analgesia for labor influences maternal satisfaction in women who initially choose natural childbirth.MethodsThis study compared pain and maternal satisfaction in women who elected natural childbirth and successfully followed through (n = 23), with those who elected natural childbirth, but requested epidural analgesia during their labor (n = 24). Subjects rated their pain throughout labor and completed pre- and postlabor questionnaires.ResultsWomen who requested epidural analgesia for pain during labor reported significantly lower pain scores than those women who had natural childbirth (P < .001). However, 88% of women who requested an epidural for pain reported being less satisfied with their childbirth experience than those who did not, despite lower pain intensity. Antenatal survey results suggest that concerns about epidurals and their effect on the baby, greater than anticipated labor pain, perceived failure of requesting an epidural, and longer duration of labor may have accounted for these findings.ConclusionsThis study examined the influence of epidural analgesia in parturients electing natural childbirth. Pain relief alone was not found to improve maternal satisfaction. This study highlights the importance of experience and prelabor expectations on maternal satisfaction with childbirth.

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