Electing the Labor Analgesia and Satisfaction of Primiparous Women: An Interventional Study of the Impact of Shared Decision-Making

Abstract

Abstract Background: Most physicians and childbirth care providers choose analgesia for mothers during labor and childbirth based on their own preference for various reasons, which sometimes leads to the mothers’ dissatisfaction with the decision made in selecting the type of labor analgesia. Present study aimed to assess the impact of shared decision-making (SDM) in electing the labor analgesia on the satisfaction of primiparous women. Methods: The present experimental study was conducted on primiparous women with a gestational age of 38- 42 weeks. The participants were assigned to the intervention (n=33) and control (n=33) groups using block randomization with block sizes of 4 and 6. Women in the intervention group decide about the type of pain relief based on SDM during the latent phase of labor after receiving the required information regarding various applicable analgesia methods. The questionnaires, including satisfaction with the decision, O'Conner’s decisional regret scale, and SDM questionnaires, were completed after childbirth. Data were analyzed by SPSS 24 software and independent t-test and ANCOVA were used. Results: The baseline characteristic of participants was similar in both groups. After the intervention, the mean score of decision satisfaction‎ in the intervention group was significantly higher than that in the control group [Mean Difference (MD): 2.86, 95% CI: 1.94to 3.77, (P <0.001)]. The mean score of decisional regret (DR) in the intervention group was significantly lower than that in the control group [MD: -4.86, 95% CI: -5.95to -3.76, (P<0.001)]. After the intervention, the mean score of SDM in the intervention group was significantly higher than that in the control group [MD: 13.22, 95% CI: 10.33 to 16.12, (P<0.001)]. The highest mean difference in the intervention group was associated with the SDM and the lowest mean difference was associated with the decisional regret . Conclusion: Participation of women in decision-making to choose the type of labor pain relief during childbirth improved decision satisfaction and perception of SDM. Therefore, it is recommended to use this method during labor and childbirth, since it is considered a patient's right and autonomy.