Effectiveness of staged nursing in reducing labor analgesia complications: a retrospective cohort study

Background The rising incidence of complications linked to labor analgesia underscores the need for targeted strategies to improve maternal outcomes. Staged nursing, a tiered approach to assessment and care, has been proposed to enhance safety and reduce adverse events during labor. Objective This study aimed to evaluate whether staged nursing care is more effective than standard nursing in reducing the complications associated with labor analgesia. Materials and methods This retrospective cohort study included 278 women who received either standard nursing care or staged nursing care during labor between January 2018 and December 2021 at a tertiary care hospital. Staged nursing involved structured assessments, continuous monitoring, and individualized interventions. The primary outcomes were the incidence of analgesia-related complications. Secondary outcomes included labor duration, analgesia dosage, and maternal satisfaction. Results The staged nursing group showed significantly lower rates of hypotension (8.6% vs. 18.0%, p = 0.03), respiratory depression (2.2% vs. 7.9%, p = 0.04), inadequate pain control (6.5% vs. 16.5%, p = 0.01), and post-dural puncture headache (2.9% vs. 10.1%, p = 0.02) than the control group. Satisfaction scores were higher in the intervention group (4.3 vs. 3.5, p < 0.001), and both labor duration and analgesia dosage were significantly reduced. Conclusion Staged nursing effectively reduces complications and improves maternal satisfaction during labor. These findings suggest that structured nursing protocols can enhance maternal safety and should be considered for integration into routine obstetric care.