OBJECTIVE:To determine the factors affecting the choice for the use or non-use and the choice for the method of analgesia for labor and delivery among obstetricians at the Philippine General Hospital.

METHODS:A cross-sectional survey was done. A self-administered questionnaire was designed based on the literature reviewed, 5 key informant interviews and 3 focus group discussions. STATA software was used for item analysis.

RESULTS: The survey had 57 respondents out of a possible total of 83, representing 69%of the target population. Mean age of the group was 35.5 years. Males accounted for 23% and females, 77%. The mean number of years in active practice was computed at 12 years. The questionnaire took an average of 3.5 minutes to accomplish. The inability to cover the entire population was due to 1) difficulty locating respondents; or 2) lost questionnaires. There was a total of 5 lost questionnaires. Item analysis using STATA yielded a valid questionnaire with good reliability for six domains (Cronbach's a ~0.6621). One domain (G) was removed in its entirety due to low reliability (Cronbach's a = 0.1510).

CONCLUSION: In general, the obstetricians are knowledgeable about the topic of pain management during labor (Domain A: Knowledge ofthe Obstetrician). From the obstetricians' point of view, the strongest agreement is seen in the previous experience of the patient and financial status as determinants of patient's choice for labor analgesia (Domain B). Most obstetricians are aware of both pharmacologic and non-pharmacologic methods of labor analgesia (Domain C: Awareness of Different Methods). Many obstetricians also recommend intravenous and intramuscular use of opioids as well as epidural anesthesia. More than two-thirds also believe that verbal assurance helps the patient in labor a lot (Domain D: Practice of Analgesia). On the part of the obstetrician, the choice of analgesia is determined by many clinical factors including gravidity, presence of comorbid conditions, the stage of labor and the safety of the method (Domain E: Clinical Factors). Lastly, considering both the obstetrician and the patient, there are also numerous non-clinical factors determining the choice for analgesia including patient finances, skill and ability of the anesthesiologist, predicted ease of delivery, and proximity of the obstetrician to the birthing place (Domain C: Non-clinical Factors).