Pharmacological Pain Relief and Women’s Satisfaction with Birth Experience: A Systematic Review

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