Epidural analgesia for labour pain in nulliparous women in Norway in relation to maternal country of birth and migration related factors

Vigdis Aasheim; Roy M Nilsen; Eline Skirnisdottir Vik; Rhonda Small; Erica Schytt

doi:10.1016/j.srhc.2020.100553

Epidural analgesia for labour pain in nulliparous women in Norway in relation to maternal country of birth and migration related factors

Sex Reprod Healthc. 2020 Dec:26:100553. doi: 10.1016/j.srhc.2020.100553. Epub 2020 Sep 7.

Authors

Vigdis Aasheim¹, Roy M Nilsen², Eline Skirnisdottir Vik³, Rhonda Small⁴, Erica Schytt⁵

Affiliations

¹ Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway. Electronic address: vaa@hvl.no.
² Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway.
³ Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway.
⁴ Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Judith Lumley Centre, La Trobe University, Melbourne, Australia.
⁵ Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway; Centre for Clinical Research Dalarna - University of Uppsala, Falun, Sweden.

PMID: 32919243
DOI: 10.1016/j.srhc.2020.100553

Abstract

Objective: To investigate associations between maternal country of birth and other migration related factors (length of residence, reason for migration, paternal origin) and epidural analgesia for labour pain in nulliparous women in Norway.

Design: Population-based register study including nulliparous migrant women (n = 75,922) and non-migrant women (n = 444,496) with spontaneous or induced labour. Data were retrieved from the Medical Birth Registry and Statistics Norway, 1990-2013. Odds ratios (OR) with 95% confidence intervals (CI) were estimated by logistic regression, and adjusted for maternal age, marital status, maternal education, gross income, birth year, hospital size and health region.

Main outcome: Epidural analgesia for labour pain.

Results: Epidural analgesia was administered to 38% of migrant women and 31% of non-migrant women. Compared with non-migrants, the odds of having epidural analgesia were lowest in women from Vietnam (adjOR 0.54; CI 0.50-0.59) and Somalia (adjOR 0.63; CI 0.58-0.68) and highest in women from Iran (adjOR 1.32; CI 1.19-1.46) and India (adjOR 1.19; CI 1.06-1.33). Refugees (adjOR 0.83; CI 0.79-0.87) and newly arrived migrants (adjOR 0.92; CI 0.89-0.94) had lower odds of epidural analgesia. Migrant women with a non-migrant partner (adjOR 1.14; CI 1.11-1.17) and those with length of residence ≥10 years (adjOR 1.06; CI 1.02-1.10) had higher odds.

Conclusion: The use of epidural analgesia varied by maternal country of birth, reason for migration, paternal origin and length of residence. Midwives and obstetricians should pay extra attention to the provision of adequate information about pain relief options for refugees and newly arrived migrants, who had the lowest use.

Keywords: Country of birth; Epidural analgesia; Immigrant; Migration; Register study.

MeSH terms

Adult
Analgesia, Epidural / statistics & numerical data*
Attitude to Health / ethnology*
Delivery, Obstetric / statistics & numerical data
Female
Humans
Labor Pain / drug therapy*
Norway
Pain Management / methods*
Pregnancy
Transients and Migrants / statistics & numerical data*