Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 30:9.
doi: 10.18332/ejm/204274. eCollection 2025.

The effectiveness of decision-making support methods during pregnancy regarding epidural analgesia in labor: A scoping review

Yaya Kishimoto #  1 , Kayo Ueda  1 , Toshiko Igarashi #  1 , Yuu Tanaka  2 , Masahiko Kawaguchi  3
Affiliations

The effectiveness of decision-making support methods during pregnancy regarding epidural analgesia in labor: A scoping review

Yaya Kishimoto et al. Eur J Midwifery. .

Abstract

Introduction: This scoping review aimed to identify effective methods used for decision-making support and their effects on women considering choosing epidural analgesia in labor.

Methods: A literature search was conducted using CHNAHL, the Web version of the Central Medical Journal, and PubMed, and articles were extracted based on the eligibility criteria in September 2024. The PRISMA-ScR was followed. Studies that compared two groups of women considering epidural anesthesia for labor (subject), decision-making support (intervention), and standard care (control) were eligible.

Results: The search identified a total of 732 articles, of which 15 were eligible. Among these, 10 were randomized controlled trials (RCTs), 1 was a non-RCT, and 4 were cohort studies. The most common decision support approach was the distribution of leaflets, which were often given in the second to third trimester of pregnancy. Outcome measurements varied, limiting the identification of the most effective approach. However, most interventions, including controls, showed some effect on improving satisfaction and knowledge. Specifically, interventions incorporating shared decision-making (SDM) influenced satisfaction with the intervention, satisfaction with the birth experience, the feeling of being supported by others, and controlling emotions and attitudes.

Conclusions: This study found that decision support methods include both expert intervention and media-based approaches. However, given the scarcity of related studies and the variability in evaluation measures, the most effective method could not be identified. Nevertheless, an SDM approach may enhance effectiveness. These findings may help those who support pregnancy and childbirth in choosing more effective decision support methods.

Keywords: analgesia; decision-making; epidural; pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors have completed and submitted the ICMJE Form for disclosure of Potential Conflicts of Interest and none was reported.

Figures

Figure 1
Figure 1
PRISMA flow diagram showing selection of included studies
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Czech I, Fuchs P, Fuchs A, et al. . Pharmacological and Non-Pharmacological Methods of Labour Pain Relief-Establishment of Effectiveness and Comparison. Int J Environ Res Public Health. 2018;15(12):2792. doi:10.3390/ijerph15122792 - DOI - PMC - PubMed
    1. Lally JE, Murtagh MJ, Macphail S, Thomson R. More in hope than expectation: a systematic review of women’s expectations and experience of pain relief in labour. BMC Med. 2008;6:7. doi:10.1186/1741-7015-6-7 - DOI - PMC - PubMed
    1. World Health Organization . WHO Labor Care Guide User’s Manual. World Health Organization. 2020. Accessed October 27, 2024. https://iris.who.int/bitstream/handle/10665/337693/9789240017566-eng.pdf...
    1. Ministry of Health, Labor and Welfare in Japan . Survey of Medical Institutions Trends of number of deliveries, Portal Site of Official Statistics(e-Stat). Ministry of Health, Labor and Welfare in Japan. Accessed October 27, 2024. https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/23/dl/02sisetu05.pdf
    1. What are patient decision aids? International Patient Decision Aid Standards Collaboration. March 13, 2024. Accessed October 27, 2024. https://decisionaid.ohri.ca/IPDAS/what.html

LinkOut - more resources