Epidural Labour Analgesia Awareness, Acceptance and Barriers Among Pregnant Women Attending Antenatal Clinic

Hafiz Muhammad Fawaad Bilal; Muhammad Imran Anjum; Saba Arif; Muhammad Muzayyan Abbas; Hareem Ali; Nabeela Jallat

doi:10.61919/59fjfs31

Authors

Hafiz Muhammad Fawaad Bilal MS Anaesthesia, Consultant Anesthesiologist, Primary and Secondary Health Care Department, Khanewal, Pakistan Author
Muhammad Imran Anjum Consultant Anesthetist, HOD Anesthesia/ICU, DHQ Hospital, Khanewal, Pakistan Author
Saba Arif Anesthetist, DHQ Hospital, Khanewal, Pakistan Author
Muhammad Muzayyan Abbas Post Graduate Resident, Mayo Hospital, Lahore, Pakistan Author
Hareem Ali Anesthetist, Eastridge Primecare Hospital, Rawalpindi, Pakistan Author
Nabeela Jallat Consultant Obstetrician Gynaecologist, Training from SPH, Quetta, Pakistan Author

DOI:

https://doi.org/10.61919/59fjfs31

Keywords:

Epidural labour analgesia; labour pain; awareness; knowledge; acceptance; barriers; antenatal counselling; pregnancy; Pakistan

Abstract

Background: Epidural labour analgesia is an effective method of labour pain relief, but inadequate knowledge, misconceptions, social influences, and limited counselling may restrict its acceptance. Objective: To assess awareness, knowledge, acceptance, misconceptions, and perceived barriers regarding epidural labour analgesia among pregnant women attending antenatal clinics in District Khanewal, Pakistan, and to identify factors associated with post-counselling acceptance. Methods: A descriptive cross-sectional survey incorporating a within-participant pre- and post-counselling assessment of stated acceptance was conducted among 423 pregnant women from January to June 2026. Data were collected using a structured interviewer-administered questionnaire. Categorical associations were examined using chi-square or Fisher's exact tests, and independent factors associated with post-counselling acceptance were evaluated using multivariable binary logistic regression. Results: Previous awareness of epidural labour analgesia was reported by 161 women (38.1%), while 112 (26.5%) had adequate knowledge. Baseline acceptance was 31.9% (135/423) and increased descriptively to 68.6% (290/423) immediately after counselling. The most frequently reported concerns were permanent back pain (61.2%), paralysis (52.0%), and harm to the baby (47.3%). Higher education (AOR 2.31, 95% CI 1.39–3.84), previous counselling (AOR 3.16, 95% CI 1.81–5.51), previous awareness (AOR 2.08, 95% CI 1.31–3.31), and family support (AOR 2.67, 95% CI 1.61–4.42) were positively associated with acceptance, whereas strong fear of complications was inversely associated with acceptance (AOR 0.39, 95% CI 0.25–0.61). Conclusion: Awareness and knowledge of epidural labour analgesia were limited, while stated acceptance was substantially higher after brief counselling. Educational, informational, familial, and fear-related factors were independently associated with acceptance, supporting the importance of accessible and culturally appropriate antenatal information

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