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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Stefan Hansson, Lund University, Sweden
- Second opponent: Professor Jone Trovik, University of Bergen
- Third member and chair of the evaluation committee: Professor Leiv Arne Rosseland, University of Oslo
Chair of the Defence
Professor II Rune Svenningsen, University of Oslo
Principal Supervisor
Professor II Anne Flem Jacobsen, University of Oslo
Summary
Pain relief during childbirth is important for many women and childbirth experience may influence women’s choices for subsequent pregnancies. The proportion of caesarean sections is increasing worldwide, and women's own request, often due to fear of pain, is one of the reasons. The aims of the thesis were twofold; 1) to investigate if there was an association between maternal birthplace and the provision of pain relief during childbirth using a register based dataset from the Medical Birth Registry of Norway, including 842.496 deliveries, and 2) to investigate safety aspects and childbirth experience in 1007 women with or without pudendal nerve block (PNB) in a clinical study.
Women who give birth in Norway, but who themselves were born in other countries, use pain relief to a different degree than the Norwegian-born population. Women from Sub-Saharan Africa were less likely to use pain relief during childbirth, and women from Latin America and the Caribbean were more likely to use pain relief, both compared to Norwegian-born women. Women giving birth spontaneously scored their childbirth experience higher (higher score means better experience) than women who had an instrumental vaginal birth (vacuum or forceps). However, women with or without a PNB did not differ in reported total childbirth experience, when stratified for mode of birth. Women with PNB did not have a higher rate of urinary retention than women without a PNB.
Maternal birthplace may have an effect on choices of pain relief when giving birth in Norway. Future research should investigate reasons for this disparity. No serious complications (urinary retention, low Apgar score, anal sphincter injury) or any differences in childbirth experience were found between women having a PNB or not. PNB may safely be applied on individual clinical indication.
Additional information
Contact the research support staff.