Labour Pain Worse Than Most Mothers Expect

Sydney Morning Herald

Monday September 6, 2004

Julie Robotham Medical Editor

Women are unprepared for the pain of childbirth, with more than half finding it more extreme than they expected, research shows.

Fewer than 10 per cent delivered their babies using only natural methods of pain control such as massage, hot packs and baths or showers, a study of nearly 500 women who gave birth at the Royal Hospital for Women at Randwick in late 2002 and early 2003 has found.

Epidurals were rated most highly by the women, with 82 per cent saying they would definitely or probably use the spinal injections in a future delivery. Pethidine was much less popular, with fewer than half of those who used it saying they would do so again.

The survey - the first in more than 10 years to evaluate Australian women's choices of birth pain relief - revealed women were twice as likely to have an epidural if their labour was during daylight hours. The disparity "may be because those giving birth at night have shorter, non-induced labours rather than the non-availability of an anaesthetist", Dr Amanda Henry wrote in the Australian and New Zealand Journal of Obstetrics and Gynaecology.

Women having their first baby were the biggest users of pain control medication. Epidural use fell from 55 per cent to 33 per cent for subsequent births, while the likelihood of pethidine being used halved to 18 per cent. Where labour was induced, epidural use was nearly doubled. Women who were attended by an obstetrician rather than a midwife also had higher rates of drug use.

Those whose cervix was dilated to seven centimetres or more on admission were half as likely to use nitrous oxide gas, pethidine or epidurals as those who arrived earlier in their labour. The longer the birth lasted, the more likely a woman would use one or more drugs. Nearly three-quarters said they were satisfied with the pain control they received.