Date of Award

8-1-2005

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

Presently, approximately two-thirds of all women in the United States receive obstetric analgesia for pain relief during labor. Much research has been done on the effects of epidural analgesia on the mother and infant including prolonged labor, lower rate of spontaneous delivery and increased risk of instrumental delivery. There is agreement in the research that epidural analgesia prolongs stage 2 labor, however, debate continues regarding the association of instrumental delivery and epidural analgesia. There is also lack of substantial research regarding discontinuing epidural analgesia late in labor and whether this affects rate of instrumental delivery.

The purpose of this study was to describe the incidence of instrumental delivery associated with labor epidurals. Also, the association between discontinuing epidural analgesia late in labor and the use of instrumental delivery was investigated. Medical records of 100 primiparas, age 15-35, who delivered at two Midwestern hospitals were examined during a retrospective chart review. Data were recorded utilizing a data collection tool developed by the researcher. Forty-nine women received labor epidurals and 51 did not. Frequencies were compared with chi square analysis to determine whether women who received epidural analgesia had a higher incidence of instrumental delivery. Further, the association between the instrumental delivery and timing of the discontinuation of epidural analgesia in labor was determined.

The findings of this study concluded that instrumental delivery was associated with the use of epidural analgesia (absolute value=7.86, df=l, p=0.005). Discontinuation of epidurals late in labor was not associated with instrumental delivery (absolute value=1.72, df=l, p=0.19). Results of this study were consistent with the majority of research reported nationally; instrumental delivery was associated with epidural analgesia. However, additional research needs to be conducted to further examine the association between discontinuation of epidural analgesia late in labor and its affect on instrumental delivery rates.

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