Barriers to Painless Labor in a University Hospital in Northern Iran

Background: Labor pain is considered one of the most intense painful experiences for women. It is not only a physical pain but, if not controlled, may cause severe mental and emotional stress and adverse consequences for both the mother and the baby. Objectives: This cross-sectional descriptive study aimed to investigate the barriers to painless labor (PL) from the perspective of anesthesiologists, obstetricians, and midwives at Al-Zahra Hospital, an academic and referral center in Guilan, Iran. Methods: Following approval from the Research Ethics Committee of Guilan University of Medical Sciences (GUMS), this study was conducted at Al-Zahra Hospital from May 2024 to June 2024. All members of the obstetrics and gynecology, anesthesiology, and midwifery departments who agreed to participate were enrolled in the survey. A checklist including demographic data and the barriers to PL in this hospital was completed. Results: A total of 65 out of 84 expected questionnaires were completely filled out, resulting in a response rate of 77.3%. The mean years of experience among participants were 9.91 ± 7.49. The primary barrier identified was obstetricians' concern about interrupting the delivery process (43 responses, 25%), followed by a lack of anesthesiologists (37 responses, 21.5%). The least reported barrier was maternal refusal (3 responses, 1.7%). Conclusions: The main barriers to PL at this hospital were the unwillingness of obstetricians to recommend PL, likely due to concerns about interference with the delivery process, and the insufficient number of anesthesiologists.