Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

Sabine L.M. Logtenberg; Corine J. Verhoeven; Katrien Oude Rengerink; Anne Marie Sluijs; Liv M. Freeman; François G. Schellevis; Ben Willem Mol

doi:10.1186/s12884-018-1986-8

Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

Sabine L.M. Logtenberg^*, Corine J. Verhoeven, Katrien Oude Rengerink, Anne Marie Sluijs, Liv M. Freeman, François G. Schellevis, Ben Willem Mol

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Fear of childbirth may reduce the womens' pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women. Methods: Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire. Results: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8-4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5-8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7-4.3). Conclusions: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.

Original language	English
Article number	347
Number of pages	9
Journal	BMC Pregnancy and Childbirth
Volume	18
DOIs	https://doi.org/10.1186/s12884-018-1986-8
Publication status	Published - 25 Aug 2018

Bibliographical note

Acknowledgements
We would like to thank all of the participants in our study and the midwives and gynaecologists of the participating practices and hospitals respectively.

Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on request.

Keywords

Epidural analgesia
Fear of childbirth
Labour pain
Pharmacological pain relief
Remifentanil-patient controlled analgesia
Wijma delivery expectancy/experience questionnaire (W-DEQ)

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Cite this

@article{4a1078431b6a4ac19442ee89618c418f,

title = "Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study",

abstract = "Background: Fear of childbirth may reduce the womens' pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women. Methods: Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire. Results: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8-4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5-8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7-4.3). Conclusions: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.",

keywords = "Epidural analgesia, Fear of childbirth, Labour pain, Pharmacological pain relief, Remifentanil-patient controlled analgesia, Wijma delivery expectancy/experience questionnaire (W-DEQ)",

author = "Logtenberg, {Sabine L.M.} and Verhoeven, {Corine J.} and Rengerink, {Katrien Oude} and Sluijs, {Anne Marie} and Freeman, {Liv M.} and Schellevis, {Fran{\c c}ois G.} and Mol, {Ben Willem}",

note = "Acknowledgements We would like to thank all of the participants in our study and the midwives and gynaecologists of the participating practices and hospitals respectively. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on request.",

year = "2018",

month = aug,

day = "25",

doi = "10.1186/s12884-018-1986-8",

language = "English",

volume = "18",

journal = "BMC Pregnancy and Childbirth",

issn = "1471-2393",

publisher = "BioMed Central",

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T1 - Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

AU - Logtenberg, Sabine L.M.

AU - Verhoeven, Corine J.

AU - Rengerink, Katrien Oude

AU - Sluijs, Anne Marie

AU - Freeman, Liv M.

AU - Schellevis, François G.

AU - Mol, Ben Willem

N1 - Acknowledgements We would like to thank all of the participants in our study and the midwives and gynaecologists of the participating practices and hospitals respectively. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on request.

PY - 2018/8/25

Y1 - 2018/8/25

N2 - Background: Fear of childbirth may reduce the womens' pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women. Methods: Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire. Results: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8-4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5-8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7-4.3). Conclusions: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.

AB - Background: Fear of childbirth may reduce the womens' pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women. Methods: Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire. Results: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8-4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5-8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7-4.3). Conclusions: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.

KW - Epidural analgesia

KW - Fear of childbirth

KW - Labour pain

KW - Pharmacological pain relief

KW - Remifentanil-patient controlled analgesia

KW - Wijma delivery expectancy/experience questionnaire (W-DEQ)

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C2 - 30144796

AN - SCOPUS:85052318206

SN - 1471-2393

VL - 18

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

M1 - 347

ER -

Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

Abstract

Bibliographical note

Keywords

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