Background::
The use of pharmacological pain relief methods during labour is increasing, however there is no
clear evidence that pharmacological interventions can also improve women’s satisfaction with birth experience.
Objective::
To assess the effectiveness of pharmacological interventions on women's satisfaction with birth experience
(primary outcome) and satisfaction with the received method (secondary outcome).
Methods::
We searched databases in English (MEDLINE, Cochrane Library, Embase, ProQuest, Scopus and Web of
Science) and Persian languages (SID and Magiran) from inception until April 30, 2018 for clinical trials that
pharmacological pain relief methods were compared with standard or routine cares, or non-pharmacological methods. The
evaluation of studies in term of risk of bias was conducted using the Cochrane Handbook. Meta-analysis results were
reported as OR and 95% confidence interval. In meta-analysis, subgroup analysis was performed based on the type of
intervention. Due to the heterogeneity of over 30%, random effect was reported instead of the fixed effect. The heterogeneity
was evaluated using I2, T2 and Chi2. The evaluation of the quality of the studies was also examined using the Grading of
Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach.
Results::
The results of 7 studies with low-quality in meta-analysis, showed that pharmacological methods significantly
improved satisfaction with birth experience (OR = 2.99; 95% CI: 1.37 to 6.52; P = 0.006). However, meta-analysis of
subgroups showed that only inhalation of Entonox gas (OR = 6.51; 95% CI: 3.47 to 12.22; P < 0.001), in contrast to epidural
analgesia (OR = 1.19; 95% CI: 0.62 to 2.27; P = 0.60) and Hyoscine injection (OR = 2.58; 95% CI: 0.93 to 7.20; P = 0.07)
significantly improved satisfaction with birth experience.
Conclusion::
Pharmacological interventions such as epidural, although introduced as one of the effective methods for pain
relief, may not provide women with satisfaction with birth. However, more studies with precise methodology, high sample
size, and standard tools should be performed to more accurately investigate the effect of pharmacological interventions on
birth experience.