Elsevier

The Lancet

Volume 320, Issue 8302, 9 October 1982, Pages 808-810
The Lancet

Occasional Survey
ANALGESIA AND SATISFACTION IN CHILDBIRTH (THE QUEEN CHARLOTTE'S 1000 MOTHER SURVEY)

https://doi.org/10.1016/S0140-6736(82)92691-5Get rights and content

Abstract

Maternal satisfaction with the experience of childbirth was investigated in 1000 women having a vaginal delivery of a live child. Effective pain relief did not ensure a satisfactory birth experience. Epidural block produced the most effective analgesia but there were more dissatisfied women among the epidural patients than among those who did not receive this analgesia (p<0·05). Bad experience scores were evaluated one year later and were clearly related to a forceps delivery and long labour, both of which were more common in the epidural group. The desirability of an "epidural on demand" service should be tested against an "epidural when necessary" service.

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    Likewise, effective pain relief does not necessarily lead to greater satisfaction with the birth experience.19,20 Actually, studies have found lower satisfaction rates in women who had epidural analgesia compared to women who experienced pain during the labour and birth.18,21 Failure to meet the woman's expectations, lack of midwifery support or a sense of loss of control, or not being involved in decision making can all contribute to lower satisfaction.22–25

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    However, women who received EDA were also more likely to have a negative childbirth experience. Perhaps the women recalled their experience of pain before they were given EDA or, as some studies have shown, effective pain relief such as EDA does not automatically result in a more satisfying childbirth experience (Morgan et al., 1982; Lind and Hoel, 1989). Waldenström et al. (1996a) have shown that pain is multidimensional and not entirely negative.

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