Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing.

This study investigated the reasons that might lead women to choose or not choose epidural analgesia as a strategy for the management of pain in childbirth. In our sample 55% of 114 women chose EA. Logistic regression resulted in a statistical model with four unique and independent predictors: Parity status and the fear of the side effects of EA each reduced the odds of choosing EA by half, whereas the desire to have a pain-free childbirth and positive experiences with EA of family and friends each doubled the odds of choosing EA. Pain catastrophizing was not related to EA use. The lack of an interrelationship between pain catastrophizing and EA use is probably due to an ambivalent attitude towards EA in pain catastrophizers. Pain catastrophizing was positively associated with the fear of being overwhelmed by labour pain and tendencies to avoid the pain, but also positively with the fear of pain during the insertion of the EA needle. Pain catastrophizing was also strongly related to recommendations to use EA from others, in particular from the midwife and from the gynecologist. Results are discussed in terms of the social impact of pain catastrophizing.