PL.57 Audit of Midwives’ Knowledge of Neuraxial Analgesia in Labour

Introduction Antenatal classes at our trust are delivered by midwives. During labour they are gatekeepers to mothers accessing different modes of analgesia. Advice to mothers should be accurate, void of misconceptions or bias. We audited midwives on their knowledge of neuraxial analgesia in labour. Methods The Obstetric Anaesthetists’ Association publication on labour analgesia was the standard for this audit.1 Midwives were audited prospectively on a one to one basis. Results Twenty seven midwives were audited. Only six perceived epidurals as the most effective analgesia in labour. Further results are depicted in Table 1. Abstract PL.57 Table 1 Midwives’ knowledge of side effects of epidurals compared to risk quoted in current guidance Side Effect Number of midwifes who knew this as a side effect (%) Actual risk Failure 20 (74%) 1 in 8 Long-term backache 5 (18.5%) No increased risk Increased risk of assisted delivery 26 (96.3%) 1 in 7 Temporary sensory loss 15 (55.5%) 1 in 1000 Increased risk of caesarean section 10 (37%) No increased risk Epidural abscess 9 (33.3%) 1 in 50 000 Adverse effects on baby 4 (14.8%) No direct risk to baby Discussion Neuraxial analgesia in labour is associated with favourable fetal acid base profiles.2 3 This audit revealed a difference in knowledge amongst midwives compared with current evidence, potentially leading to mothers being misinformed on labour analgesia. A comprehensive education programme delivered by anaesthetists to midwives will address misconceptions and increase awareness on labour analgesia, ensuring mothers are provided with accurate evidence based information. References Information for Mothers Subcommittee of the Obstetric Anaesthetists’ Association. Pain Relief in Labour. 2012, third edition. www.oaaformothers.info Jones L, Othman M, Dowswell T, et al, Pain management for women in labour: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD009234. DOI: 10.1002/14651858.CD009234.pub2. Reynolds F. Labour analgesia and the baby: good news is no news. International Journal of Obstetric Anaesthesia 2011;38–50.