RESULTS
Demographic characteristics of respondents
A total of 543 respondents were recruited for this study. Data for three were excluded from the analysis because they later refused to participate in this study. Therefore, data for 540 respondents were included in the analysis.
The data analysed showed that 477 (88.3 %) of the respondents that were recruited for this study were within the age range of 25-34 years old, 27 (5.0 %) were within the age bracket of 15-24, whereas 36 (6.7 %) were within 35-45 years old (Table 1) .  We assessed the educational background of the respondents and realized that 37 (6.9 %) attained tertiary education, 205 (37.9 %) had high school education, 101 (18.7 %) had primary school education, whereas 197 (36.5 %) had no formal education (Table 1) . The data also showed that 477 (88.3 %) of the respondents had their gestational age between 36-40 weeks old and 63 (11.7 %) were above 40 weeks of gestation (Table 1). 
Awareness of epidural labour analgesia service at the delivery unit of the Tamale Teaching Hospital.
To investigate the causes of low patronage of the epidural labour analgesia service at the delivery unit of the Tamale Teaching Hospital, we first assessed respondent’s awareness of the epidural labour analgesia service available at the delivery unit of the Tamale Teaching Hospital. We asked the respondents to know if they were aware that labour pain could be managed during childbirth. The data showed that 339 (62.8%) of the respondents were not aware that labour pain could be managed during childbirth, 108 (20.0 %) of them indicated that labour pain could not be managed, and 93 (17.2 %) of them said labour pain could be managed (Table 2) . We again assessed respondent’s awareness of the various options of labour analgesia services available at the delivery unit of the Tamale Teaching Hospital. We observed that 2 (0.4 %) of the respondents were informed of IV/IM injections (analgesic), 527 (97.6 %) were informed of epidural labour analgesia services, 1 (0.2 %) was informed of deep breathing exercise, while 7 (1.3 %) were informed of all the options available at the delivery unit of the Tamale Teaching Hospital (Table 2) . The data also revealed that only 1 (0.2 %) of the respondents have ever received epidural labour analgesia service for childbirth (Table 2).
Determinants of epidural labour analgesia acceptance at the delivery unit of the Tamale Teaching Hospital during childbirth.
To investigate whether labour pain intensity influences the decision of women to accept labour analgesia or not, we first assessed pain experienced during childbirth. It was revealed that 172 (38.1 %) suffered severe pain, 359 (66.5 %) experienced excruciating pain, while 9 (1.7 %) reported moderate pain (Table 3) . Fear of labour pain was assessed. We observed that 456 (84.4 %) expressed very much fear for pain, 66 (12.2 %) expressed much fear for pain, 17 (3.2 %) indicated moderate fear for pain and only 1 (0.2%) expressed mild fear for pain (Table 3) . Respondents were asked if they would like to deliver babies without experiencing much pain. 503 (91.5 %) indicated that they would very much like to deliver babies without suffering from severe labour pain(Table 3) .
We assessed the individual respondents to know if age or educational background could influence epidural labour analgesia use. We observed that 233 (43.1 %), 210 (38.9 %) and 35 (6.5 %) of the respondents within the age range of 25-34 and 35-45years old who experienced severe or excruciating labour pain respectively refused to consider epidural labour analgesia services at the delivery unit (Table 4) . Conversely, 11 (2.0 %) and 15 (2.8 %) of the respondents within the age range of 25-34 and 35-45 years old who experienced severe or excruciating labour pain respectively would like to receive the epidural labour analgesia service during childbirth (Table 4) . The data suggested that 167 (30.9 %) and 29 (5.4 %) who had no formal education and experienced severe or excruciating labour pain respectively refused to accept epidural labour analgesia for childbirth. Also, 79 (14.6 %) and 18 (3.3 %) who had primary school education and experienced severe or excruciating labour pain respectively refused to receive an epidural for labour analgesia, whereas 8 (1.5 %) and 188 (34.8 %) who had high school education and complained of severe or excruciating pain respectively also refused to accept epidural labour analgesia (Table 4) .
The univariate ordinal logistic regression model is presented in Table 5 to reflect the associations between potential covariates and labour pain level. The data showed that age, educational background, and religion were not associated factors to predict labour pain experienced by a patient (categories: ‘Moderate pain’, ‘Severe pain’ ‘Excruciating pain’).
We asked respondents to know why they would not accept epidural for labour analgesia during childbirth. 63 (11.7 %) of the respondents indicated that they were been advised by their midwives not to accept the epidural labour analgesia, whereas 112 (20.7 %) of them refused to accept epidural labour analgesia to be identified as a true mother and have much love for their babies (Table 6) .