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Gaceta Sanitaria

Print version ISSN 0213-9111

Abstract

GARCIA-DE-DIEGO, José María  and  SERRANO-DEL-ROSAL, Rafael. Universalization, parity and evolution of the demand of epidural analgesia in labor in Andalusia (Spain). Gac Sanit [online]. 2019, vol.33, n.5, pp.427-433.  Epub Dec 23, 2019. ISSN 0213-9111.  http://dx.doi.org/10.1016/j.gaceta.2018.05.002.

Objective

Assess whether the universalization of epidural analgesia supplied in hospitals of the Andalusia Public Health Service (SSPA) has ended up with the inequalities shown in previous studies regarding to their demand: the percentage of women who rejected epidural analgesia was higher among the users having low educational level, lower income and working as housekeeper.

Method

The data are based on satisfaction surveys conducted by the Institute for Advanced Social Studies amongst of SSPA users. This survey includes a section aimed at women attended in labor (N = 21,300). The hierarchical segmentation analysis shows which variables are the ones that discriminate most in the usage of epidural analgesia. Subsequently, through a model of binary logistic regression we analyze which socio-demographic variables are significant (2012) and how its impact is on the choice of epidural analgesia in childbirth.

Results

Overall, the socio-demographic variables of the users are statistically significant in the demand or not of epidural analgesia during labor. However, the detailed analysis of the last year (2012) shows that none of the socio-demographic variables introduced in the model has a significant effect on the decision of using epidural analgesia.

Conclusions

The process of universalization of epidural anesthesia in childbirth has ended with social inequalities in their use, that is, with those differences that are not due to a real choice but are induced by socio-cultural characteristics of women.

Keywords : Epidural analgesia; Health system; Pain; Social identity; Childbirth; Quantitative research.

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