Evaluation of the effects of epidural analgesia on birth trauma and mother-baby bonding quality in patients who had normal birth with epidural analgesia

Introduction and Aim: Childbirth is one of the most significant and transformative experiences in a woman's life, encompassing both physiological and psychosocial complexities. Epidural analgesia contributes to making the birthing process more tolerable by providing effective pain control. This study aims to compare Visual Analog Scale (VAS) pain scores, childbirth satisfaction, perception of birth-related trauma, desire for future pregnancy, and the quality of maternal-infant bonding between pregnant women who received epidural analgesia and those who did not. Materials and Methods: This prospective study was conducted between June 1, 2024, and October 31, 2024, at the Department of Obstetrics and Gynecology of Adıyaman University Training and Research Hospital. A total of 80 pregnant women were included: 40 received epidural analgesia (Group E) and 40 did not (Group K). In Group E, an epidural catheter was placed, and analgesic agents were administered under hemodynamic monitoring upon the onset of labor pains, with repeat doses given as needed. The catheter was removed at 24 hours postpartum. Group K received routine care without any additional procedures or medications. VAS pain scores were recorded after delivery, at the second postpartum hour, and prior to discharge. Patient satisfaction and early breastfeeding were evaluated before discharge. At one month postpartum, participants completed a questionnaire titled "Evaluation of the Effects of Epidural Analgesia on Birth Trauma and Maternal-Infant Bonding in Patients Undergoing Normal Vaginal Delivery with Epidural Analgesia," which included the City Birth Trauma Scale and the Maternal Attachment Scale. Results: The study included 80 women, with 40 in each group. VAS scores at the time of delivery, at the second postpartum hour, and prior to discharge were significantly lower in Group E (p=0.000, p=0.000, and p=0.004, respectively). Women in Group E reported higher satisfaction with their birth experience and more positive perceptions of childbirth. The intention to conceive and give birth again was significantly higher in Group E compared to Group K (p=0.024). The proportion of participants expressing a preference for epidural analgesia in future deliveries was also significantly higher in Group E (p=0.001). No significant difference was observed in maternal attachment scores between the groups (p=0.386), and early breastfeeding outcomes were comparable. The avoidance subscale score of the City Birth Trauma Scale was significantly lower in Group E than in Group K (p<0.05), while other subscales—re-experiencing symptoms, negative cognitions and mood, hyperarousal, and dissociation—did not show significant differences. Conclusion: The findings indicate that epidural analgesia not only provides effective pain management during labor but also contributes to a more positive childbirth experience and potentially enhances the maternal-infant bonding process. Effective pain control during delivery is an important factor in promoting maternal psychosocial well-being. Therefore, when selecting labor analgesia methods, both physiological outcomes and psychosocial aspects should be considered. Keywords: Epidural analgesia, birth trauma, maternal-infant bonding, childbirth satisfaction, pain management.