Resultados Clínicos e Satisfação com Analgesia Intratecal no Trabalho de Parto: um Estudo Quase-Experimental Prospetivo com Contributos de Photowalk

ABSTRACTIntroduction: Labor pain significantly influences maternal experience, satisfaction, and childbirth outcomes. This study compared clinical outcomes and maternal satisfaction following intrathecal bupivacaine with opioids versus no analgesia and explored emotional experiences using a mixed quantitative–qualitative photowalk approach. Methods: A prospective, quasi-experimental study was conducted among 126 parturients ≥37 weeks in active labor, assigned to intrathecal labor analgesia (LA; n=63; bupivacaine 2 mg, morphine 0.2 mg, fentanyl 25 µg) or without labor analgesia (WoLA; n=63). Outcomes assessed included pain relief, hemodynamic stability, labor progress, neonatal wellbeing, and satisfaction.Results: Baseline pain was comparable (p=0.195). Within five minutes, the LA group achieved near-complete analgesia (0.05±0.21 vs 9.52±1.17; p=0.001). At 30 minutes, contractions were longer and more effective in the LA group (38.60±7.33 vs 31.52 ±4.87 s; p=0.005). Neonatal 1-minute APGAR scores were higher with LA (7.09±1.30 vs 6.54±1.43; p=0.025), and fetal complications were lower (4.8% vs 15.9%). Total labor duration was significantly shorter (4.08±2.56 h vs 8.59±4.48 h; p<0.001). In the LA group, 79.4% of women reported very high satisfaction. Photowalk analysis demonstrated visible emotional ease following analgesia, while WoLA participants expressed fulfilment through endurance. Conclusion: Intrathecal bupivacaine with opioids provides rapid, effective labor analgesia, improves maternal, clinical and neonatal outcomes, and achieves high satisfaction in low-resource settings. Photowalk findings reveal that maternal satisfaction encompasses not only pain control, but also emotional resilience, perceived safety, and trust in care.