• Semra Ozdemir, Teresa Chen, Chin Wen Tan, Wei Han Melvin Wong, Hon Sen Tan, Eric Andrew Finkelstein, and Ban Leong Sng.
• Health Services and Systems Research, Duke-NUS Medical School, Singapore.
• Patient Prefer Adher. 2022 Jan 1; 16: 983-994.

ObjectiveThe objective was to investigate the extent to which treatment benefits, risks and costs affected parturients' preferences for labor analgesia.MethodsWe recruited 248 healthy parturients prior to labor at an antenatal ward and administered a discrete choice experiment survey. Parturients were asked to choose among four hypothetical forms of labor analgesia: epidural analgesia, pethidine, Entonox and no analgesia, which were defined by: pain score, duration of second stage of labor, risks of instrumental delivery, back pain and permanent nerve injury, and out-of-pocket cost. We used mixed logit model to calculate the relative importance of each attribute (out of 100).ResultsParturients preferred receiving labor analgesia over not receiving analgesia and those who had positive past experience with epidural preferred epidural over other modalities. Out-of-pocket cost (28%), duration of second stage of labor (26%) and pain score following treatment (18%) were the most important attributes.ConclusionOut-of-pocket cost was a major concern. Parturients prioritized having lower pain and shorter labor experience over risks associated with epidural analgesia. Parturients should be presented with realistic range of risks of side-effects so that they can decide how to balance risks against benefits and costs associated with child labor.© 2022 Ozdemir et al.

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