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KNOWLEDGE AND ATTITUDE OF ANTENATAL MOTHERS TOWARDS EPIDURAL ANALGESIA FOR LABOUR PAINS IN UNIVERSITY OF NIGERIA TEACHING HOSPITAL (UNTH) ITUKU-OZA; A, ENUGU.


Project topic for Nursing Science department

CHAPTER ONE

1.1     Background of the Study:

Pain relates to a sensation that hurts, it is a very individual experience and only the person who is experiencing the pain can describe it (Med-News journal 2015). Labour pain is one of the most severe pains that women experience during their life (Barakzai, Haider, Yousuf, Ambreen & Mohammed, 2010). The excruciating nature of the pain of labour makes it an experience most women will want to avoid. For an expectant mother, labour pains would always be a source of worry and pain relief agents or method would remain of much interest, (Jones, Othman, Dow Swell, Alfirevic, Gates, Newburn, 2012).

          Pain relief is an integral part of labour management. Pain relief management during labour has undergone various advancement since 1847 when Simpson found that chloroform could help relieve the pain women felt during labour. These findings were not received favourably on religious and medical grounds, (Jones 2002). Childbirth was viewed as a physiological process best managed with a little interference as possible.

Queen Victoria was given chloroform by John Snow for the birth of her eight child and this did much to popularize the use of pain relief in labour. Many women go into labour unaware that they may need relief, although 75% of first time mothers experience sufficient pain for them to request pain relief (Aitkenhead, Smith and Rowbotham 2007).

Lack of knowledge regarding birth process can influence a woman’s attitude to pain relief. A knowledgeable woman may understand labour pains and positively view her pains as a sign of progress. Pain, a sense of accomplishment and enjoyment are all experienced during labour as a result some women may refuse pain relief. Several strategies and alternative therapies have been used to provide analgesia for labour pain. Over the last few years, a number of improvements have enhanced the efficacy and safety of neuraxial analgesia and ultimately have improved mothers satisfaction with their birth experience.

Epidural Analgesia is the most effective form of analgesia in labour, with up to 90% of women reporting complete or near complete pain relief. (Aitkenhead et al 2007). In most of the communities now, it is the preferred technique of analgesia for labour.

1.2     Statement of the Problem

In the United Kingdom, 90% obstetric units offer 24-hr epidural service with a high level of acceptance. (Burstein, Buckland & Pickett 1999). In Canada, the epidural rate varies between the provinces from 30% to 69% (Canadian Institute of Health Information, 2009). The use of epidural anaesthesia in the US has tripled between 1981 and 2001, with 60% of women using technique in large hospitals, (Bucklin, Hawkins, Anderson and Wlinch 2005). In Pakistan, epidural analgesia is a relatively new concept being available in few hospitals. Although information on epidural analgesia is provided to parturient, refusal rate is high, (Minhas, Kamal, Afshan and Paheel 2005). In Nigeria, there is little information on the views of pregnant women about epidural analgesia during labour and in most Nigerian obstetric units, it is not available. (International Journal of Obstetric Anaesthesia 2009).

The researcher having undergone training in anaesthesia and on being faced with a challenge of writing another research thought to herself “are women aware of pain free labour?, it is being utilized in this Teaching Hospital?” (U.N.T.H, Enugu). Further investigation and data collected from the labour ward in U.N.T.H from 2015-2017 showed that only if (four) paturients have demanded and utilized the services. One tends to wonder if our people are aware of pain free labour, why it not being utilized despite available trained personnel, is it that our women are so used to labour pains that they see it as a sign of accomplishment?. This study was born out of these observations/questions and the researcher seeks to find out the knowledge and the attitude of mothers towards epidural analgesia in labour.

1.3     Purpose of the Study

The purpose of this study is to assess the knowledge and attitude of antenatal mothers towards epidural analgesia for labour in the University of Nigeria Teaching Hospital (U.N.T.H), Ituku-Ozalla Enugu.  

1.4     Objectives of the Study

To determine knowledge of epidural analgesia in labour by mothers attending ANC at UNTH

To identify mother various source of information on epidural analgesia in UNTH

To ascertain their knowledge of its benefits and complications.

To verify mothers attitude towards epidural analgesia for labour in UNTH.

1.5     Research Questions

Are antenatal mothers knowledge of epidural analgesia in labour?

2.    What are their sources of information to mothers attending ANC at UNTH?

3.    Are they aware of its benefits and complications?

4.    What is the attitude of mothers towards epidural analgesia for labour?

1.6     Significance of the Study

Results from this study will determine the level of awareness of antenatal mothers to epidural analgesia in labour.

The study will enable mothers make choice of the type of labour they would undergo.

The study will enlighten mothers on the benefits and complications of epidural analgesia in labour.

The research will serve as a reference point for further study in the field of labour.

1.7     Operational Definition of Terms

ANTENATAL MOTHERS     -        Mothers who are pregnant and coming for prenatal care 

LABOUR PAIN   -        Painful sensation occurring at the end of pregnancy which results to the expulsion of the uterine content.

EPIDURAL ANALGESIA      -        A technique of managing pain in which narcotics are infused into the epidural space through an indwelling catheter.

ATTITUDE:      - A predisposition or a tendency to respond positively or negatively towards a certain idea, object, person, or situation.

  KNOWLEDGE: -        Is a familiarity, awareness or understanding of someone or something, such as facts, information, descriptions or skills, which is acquired through experience or education by perceiving, discovering or learning. 


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