Variables Contributing to Women’s Prelabor Beliefs about Epidural Analgesia: Results of a Randomized Controlled Trial in Dutch Women

Anouk van den Bosch, Mariëlle E.J.B. Goossens, Bjorn Winkens, Jan Nijhuis, F.J.M.E. Roumen, Martine M. L. H. Wassen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademic


Introduction: Multiple factors influence a woman’s choice for Epidural Analgesia (EA) during labor. The aims of this study were to explore variables contributing to antepartum beliefs about EA, and factors influencing the experience of childbirth pain. Methods: Women (n=446) who were randomly allocated to routine EA or analgesia on request, filled in the Beliefs About Epidural Questionnaire (BEAQ) and Pain Catastrophizing Scale (PCS) before randomization, and the Child Birth Experience questionnaire (CEQ) six weeks after delivery. Results: Multiple linear regression showed a significant association between PCS score and every subscale of the BEAQ (p<.001): women with negative thoughts about pain expressed a more positive attitude towards EA, were more positive about others recommending EA, and were less confident about their ability to tolerate pain and give birth without EA. In women who requested pain relief, a significant association was found between catastrophizing about pain before delivery and a negative childbirth experience after delivery (r=.25, p=.004). Conclusion: Pain catastrophizing is the most important factor associated with beliefs about EA and the feelings about childbirth after delivery, which should especially be accounted for in young, nulliparous women with lower education. These results contribute to make a tailor-made pain management plan for women during pregnancy based on catastrophizing thoughts.
Original languageEnglish
Article number133
Number of pages7
JournalChronic Pain & Management
Issue number3
Publication statusPublished - 2020

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