Pregnant adolescents' preferences for labor pain management

Objectives: The purpose of this study was to examine the obstetric anesthesia method used, based on the patient's age. Confounding variables analyzed were the effect on labor pain management choices of parity, race, prenatal care participation, insurance status, and length of labor. Methods: This was a case control study from the Medical University of South Carolina (MUSC). The primary outcome measured was regional anesthesia (RA) use in labor. The exposure groups were based on the patient's age. All women aged 11 years and older who delivered vaginally from 1996 to 2001 were included; 7,583 patients met inclusion criteria. Results were analyzed using chi(2) statistic, univariate analysis, ANOVA, and logistic regression. Results: We found that primiparous adolescents used RA less than primiparous women over age 20. This association is not found in multiparous teens. Patients with shorter labors, black women, those without prenatal care, and older patients lacking private insurance declined RA more often. Conclusions: RA is the most utilized form of obstetric pain management in the last decade. In primiparous adolescents, declining RA cannot be explained by length of labor, race, insurance status, or prenatal care participation.