The effects of a prenatal labor analgesia education program on outcomes for primiparas: A randomized controlled trial

BACKGROUND: Despite the proven efficacy of labor epidural analgesia, its utilization in China remains suboptimal, particularly among primiparous women. Providing relevant health education during routine prenatal care appears to be a viable approach. OBJECTIVE: To examine the effects of an online and offline prenatal labor epidural analgesia education program on labor epidural rates in primiparas. DESIGN: A single-blinded, parallel-group randomized controlled trial. SETTINGS AND PARTICIPANTS: A total of 196 couples (primipara and spouse) were recruited from a tertiary hospital in Shenzhen, China. METHODS: The couples were randomly allocated to the intervention or control groups with usual care only. The intervention comprised a series of web-based educational modules covering fundamental aspects of labor epidural analgesia, such as indications and contraindications, along with four weekly WeChat reminders. Additionally, participants received one group face-to-face education session lasting 30 min and one individual consultation of 10-15 min. Study outcomes included the rate of labor epidural analgesia, primiparas' intention to use labor epidural analgesia, fear of childbirth, and epidural analgesia-related misconceptions among couples. Data were collected at baseline (T0), immediately post-intervention (T1), and 12 weeks post-intervention (T2). The effects of the intervention were evaluated using generalized estimating equation models. RESULTS: The intervention group had a significantly higher labor epidural analgesia rate than the control group after childbirth (P = 0.001). Primiparas in the intervention group showed significantly greater improvements in intention to use labor epidural analgesia at T1 (P < 0.001) and T2 (P = 0.014), compared with the controls. In addition, primiparas in the intervention group demonstrated a significantly greater reduction in misperceptions of labor epidural analgesia at T1 (P < 0.001) and T2 (P = 0.040) compared with the control group. Decreased primiparas' fear of childbirth and spouses' misperceptions of epidural analgesia were found in the intervention group, but no significant group-by-time effect was detected. CONCLUSIONS: The online and offline prenatal labor epidural analgesia education program was effective in increasing labor epidural analgesia rates and in reducing misconceptions about labor epidural analgesia. However, the program had limited effects on reducing primiparas' fear of childbirth and correcting spousal misconceptions about labor epidural analgesia. We recommend that midwives and obstetric nurses provide online-offline labor epidural analgesia education during routine prenatal visits. REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400079767).