Factors Influencing the Rejection of Neuraxial Analgesia for Childbirth by Pregnant Women: A Cross-Sectional Study at a Single Medical Cente

Background: One of the main reasons women prefer cesarean surgery is their fear of pain during natural process of childbirth. Neuraxial analgesia is a beneficial option for decreasing pain during natural childbirth. However, painless childbirth is still not widely accepted by parturient in developing countries compared to high-resource countries due to cultural issues and lack of knowledge. We investigated the causes of rejecting neuraxial painless childbirth in parturient admitted to the labor ward of our hospital. Methods: A total of 567 parturient who declined neuraxial analgesia for painless labor were included in this single center cross-sectional study conducted between 2020 and 2022. The causes of refusal and level of knowledge were evaluated using a validated and reliable questionnaire. Results: The main reasons for patients' refusal of neuraxial analgesia were fear of neuraxial complications, concern about insertion of the spinal needle, and worry about prolonging labor time following neuraxial analgesia, respectively. 51 participants had high, 134 had medium and 381 had low awareness level. Parturient who attended prenatal classes as well as those who used internet as a source of information had significantly higher levels of awareness. Conclusion: Fear of neuraxial complications, spinal needle and delaying childbirth were the primary reasons for maternal rejection. The women's knowledge about neuraxial painless labor was inadequate