Pharmacological Pain Relief and Women’s Satisfaction with Birth
Experience: A Systematic Review
Abstract
Background: There is an increasing interest in health care systems
worldwide for maternal satisfaction with childbirth experience. The WHO
launched a recommendation in 2018 regarding women’s right to equal
intrapartum care, where the importance of pharmacological pain relief
was highlighted. Objectives: To assess the current knowledge regarding
the impact of obstetric pharmacological pain relief on maternal
satisfaction with childbirth. Search strategy: Pub Med, Cochrane, EMBASE
and CINAHL were searched for studies in English language, published
after 1999 that investigated the effect of pharmacological pain relief
on women’s birth satisfaction after vaginal delivery. Selection
criteria: Studies reporting assessments of subjective satisfaction with
childbirth in women planned for vaginal delivery Data Collection and
Analysis: Results were summarised qualitatively. A forest plot is
presented for the five studies where comparable association measures
were available. Due to the heterogeneity between studies and
indirectness of measuring instruments, no meta-analyses were performed.
Main Results: In total, 8,847 women were included from 11 studies: one
randomised controlled study, ten observational studies, all with
moderate or high risk of bias. Inconsistent methods were used to measure
outcome; consequently, no conclusion could be drawn regarding a possible
correlation between pharmacological pain relief and birth satisfaction.
Conclusions: This systematic review could not show a correlation between
pharmacological pain relief and women’s experiences of childbirth,
mainly because a large heterogeneity between the studies. In order to
evaluate pain relief during labour and improve women’s childbirth
experiences, high quality research is urgently needed. Keywords
Childbirth-satisfaction, Birth-experience, Pharmacological pain relief,
pregnancy, labour