The effect of studying Obstetrics on the opinion of students regarding the use of epidural anaesthesia during a natural labour

Katarzyna Stawicka
Joanna Gotlib
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Warszawski Uniwersytet Medyczny, Wydział Nauki o Zdrowiu, kierunek: położnictwo
Zakład Dydaktyki i Efektów Kształcenia Wydziału Nauki o Zdrowiu, Warszawski Uniwersytet Medyczny, Warszawa, Polska

Abstract

Introduction and Objective: The pain of labour is one of the most intense pain sensations in a woman’s life. The pain may affect the condition of both the mother and the child. The most effective pain control method at present is epidural anaesthesia (EA). The aim of the study was to assess the influence of the content of courses for Obstetrics students on their opinions regarding epidural anaesthesia.

Material and Methods: The study involved 170 students of Obstetrics at Warsaw Medical University, with 80 (47%) first-year students (1Y) and 90 (53%) third-year students (3Y). The study participants voluntarily completed an anonymous questionnaire designed by the authors. Statistical analysis (STATISTICA 9.0) used the non-parametric Manu-Whitney U test (p<0.05).

Results: Both 1Y (37%) and 3Y (54%) students regarded EA as the most effective method of pain control. A higher proportion of 3Y (84%) than 1Y students declared familiarity with subarachnoid anaesthesia (p<0.009) and opioids (p<0.001). 3Y students (54%) pointed to EA as the most effective method more often (p<0.024) than 1Y students (37%). Situations that would make the students use EA during delivery were delivery in a patient with a low pain threshold (1Y 72%, 3Y 81%), and prolonged delivery (1Y 47%, 3Y 59%). 53% of the students stated that EA should be free of charge for patients with medical indications, 38% believed that EA should be free of charge. 77% of the students believed that lack of funding is the reason why EA is not used in Poland. 42% of 3Y and 12% of 1Y students (p<0.001) pointed to staff shortages. 1Y students pointed to interference with the natural course of delivery as the reason for not using EA significantly more often (37%) than 3Y students (8%).

Conclusions: 1. 1Y students expressed a negative attitude to EA, which may be due to the fact that class topics at the beginning of studies are solely concerned with natural birthing. 2. Course content during 1st cycle studies did influence students’ opinions regarding the use of EA during a natural delivery. 3. 3Y students were in favour of using EA, which may be associated with greater practical experience and more extensive theoretical knowledge.

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