Medically induced labor: Epidural analgesia and women’s perceptions of pain in early labor
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Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
Clinic of Anesthesia, Children, Circuits and Women, Aalborg University Hospital, Aalborg, Denmark
Mech-Sense (Center of Pain and Gatroenterology Research), Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Laura Kjær Jacobsen   

Clinical Institute at Aalborg University Hospital. Clinical Nurse Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, 9000 Aalborg, Denmark
Publication date: 2018-11-16
Submission date: 2018-09-04
Final revision date: 2018-10-15
Acceptance date: 2018-11-03
Eur J Midwifery 2018;2(November):15
Approximately 25% of all deliveries in Denmark are medically induced, typically characterized by more intense uterine contractions. The aim of this paper is to investigate the differences in the administration of epidural analgesia and pain experience between spontaneous and medically induced labor in nulliparous and multiparous women.

This is a prospective case-controlled study of 100 participating women in labor. The primary outcome was the timing of administration of epidural analgesia, by delivery progression and frequency. Pain scores were indicated by the McGill Pain Questionnaire and the duration of pain was also notified.

In nulliparous and multiparous women, medically induced labor was associated with earlier administration of epidural analgesia in relation to the onset of labor pain, compared to women with a spontaneous onset of labor (10.4 vs 26.10 hours, p=0.0). There was a trend, however not statistical, in the use of epidural analgesia in relation to delivery progression, assessed as dilation of the cervix (3 cm vs 4.5 cm, p=0.07) and towards higher frequency for medically induced labor (51.5% vs 32.8%, p=0.07). In nulliparous women, a reduced period of labor pain was shown in medically induced deliveries compared to spontaneous deliveries (9.30 vs 19.00 hours, p=0.03). However, no significant differences in experienced pain were shown (Score: 28.70 vs 29.60, p=0.194).

Epidural analgesia was administered earlier, and duration of experienced pain was shorter in medically induced labor, in comparison to spontaneous deliveries. However, the experienced pain was not different, possibly explained by a more intense labor process.

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