Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria

The aim of this study was to assess the utilization of epidural analgesia, its determinants and deterrents among Obstetricians. A questionnaire-based cross-sectional study was conducted among obstetricians who attended the Annual Scientific Conference of the Society of Gynecology and Obstetrics of Nigeria in 2016. A total of 324 questionnaires were analyzed using Epi-info statistical software. Knowledge of epidural analgesia was high (100%), while availability was 77.8%, however only about 25.9% routinely prescribed it. The majority (96.2%) of the respondents practiced in tertiary health facilities in urban locations (94.1%). Almost three quarter (237/324; 73.1%) of respondents were males while 87(26.9%) were females. Female obstetricians were more likely to prescribe epidural analgesia for pain management in labor (68.9% vs 63.3%, P value = 0.001). The greatest impediment to its use was the cost (69.4%), lack of skill (27.8%), client’s refusal (13.9%) and fear of complications (10.2%). Over 95% of obstetricians whose patients had used epidural analgesia expressed satisfaction and good fetomaternal outcome of labor. There is a huge disparity between knowledge of epidural analgesia and actual practice among obstetrician. In closing this gap, obstetricians must do more to adequately educate patients on the options of pain relief and routinely offer it for a satisfying birth experience.