KNOWLEDGE, ATTITUDE, DESIRE, AND FACTORS ASSOCIATED WITH LABOR PAIN MANAGEMENT AMONG PREGNANT WOMEN ATTENDING ANC IN SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE

Abstract

SUMMARY BACKGROUND: Labor pain is among the most intense pains women experience during childbirth, with significant implications for both mother and fetus if left untreated. Despite its natural and self-limiting nature, low awareness and negative attitudes toward labor analgesia remain challenges that impact maternal and fetal outcomes. The intensity and perception of labor pain vary among women, influenced by their knowledge and awareness of pain management. This study aims to assess pregnant women's awareness, attitudes, and desire for labor analgesia, along with associated factors, providing valuable insights into improving pain management during childbirth. OBJECTIVE: To assess the knowledge, attitudes, desire, and associated factors related to labor pain management among pregnant women attending antenatal care at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, from April to June 2024. METHODS: An institution-based cross-sectional study was conducted among 417 pregnant women attending antenatal care at St. Paul's Hospital Millennium Medical College from April to June 2024, using simple random sampling. Data were collected through a structured questionnaire using Kobo Toolbox and analyzed using SPSS version 26. Descriptive statistics, including frequencies, means, standard deviations, and percentages, were computed and presented in tables and figures. To examine associations between predictor and outcome variables, binary and multinomial logistic regression analyses were performed. Odds ratios with 95% confidence intervals were calculated to determine the strength of associations, and a p-value of less than 0.05 was considered statistically significant. RESULTS: A total of 417 pregnant women participated in the study. Only 55 (13.2%) of the participants were aware of labor analgesia. In the multivariate analysis, a significant association was observed between income and awareness of labor analgesia. Women with an income of 5,000 ETB or more were nearly twice as likely to be aware of labor analgesia compared to those earning less than 5,000 ETB (AOR: 1.9, 95% CI: 10.7–23.3). A significant association was found between occupation and attitudes toward labor analgesia. Employed women were 1.62 times more likely to believe that labor pain should be managed compared to unemployed women (AOR: 1.62, 95% CI: 1.02–2.59). Additionally, income played a role, with women earning 50,000 ETB or more being 1.49 times more likely to have a favorable attitude toward labor analgesia than those with lower incomes (AOR: 1.49, 95% CI: 1.10–2.59). Parity and education were significantly associated with the desire for labor analgesia. Nulliparous women were less likely to believe in the need for labor pain treatment compared to parous women (AOR: 0.65, 95% CI: 0.28–0.93). Conversely, parous women were less likely to desire labor analgesia for their next delivery compared to nulliparous women (AOR: 0.38, 95% CI: 0.20–0.52). Educated women were significantly more likely to desire labor analgesia for their next delivery, being 4.27 times more likely to express this preference than those with no formal education (AOR: 4.27, 95% CI: 2.07–14.28). CONCLUSION: Awareness of labor analgesia among pregnant women was low, highlighting significant gaps influenced by socioeconomic and educational factors. Collaborative efforts and targeted interventions are needed to improve attitudes and increase the desire for labor analgesia. Accessible healthcare policies can address these gaps, enhancing maternal care quality and improving childbirth experiences. Keywords- Labor pain management / pregnant women / SPHMMC/ Addis Abeba