Primiparous and multiparous women's birthing experiences and satisfaction with pain management in the first and second stages of vaginal delivery—A prospective cohort study

Abstract

Introduction: Most women are satisfied with their delivery experience but the effects of pain relief and different pain relief methods on the birthing experience remain inconsistent. We wanted to evaluate the impact of pain relief on the birthing experience during the first and second stages of labor among primiparous and multiparous women. Material and Methods: A total of 2042 parturients (953 primiparous and 1089 multiparous women) completed a questionnaire on the second day after vaginal delivery and, using visual analogue scale (VAS), assessed their experience and satisfaction with their pain management during the first and second stages of labor. The experiences of primiparous and multiparous women were compared, and the factors associated with positive and negative birthing experiences were ascertained. Results: Overall birthing experience was better among multiparous than among primiparous women (VAS 8.6 vs. 8.0; p < 0.001). Reported satisfaction with pain management revealed no significant differences between multiparous and primiparous women during the first stage of labor (VAS 8.2 vs. 8.1) or the second stage of labor (VAS 7.8 vs. 7.7). Some variation was reported in satisfaction with the various pain management methods, epidural and spinal block having the highest ratings during both stages of labor. However, despite differences in satisfaction with pain management, in overall birthing experience, no difference according to pain relief administered was reported among multiparous and only minor differences in primiparous women in the second stage of labor. Those parturients reporting negative birthing experiences (VAS ≤5) reported relatively high satisfaction with pain management during the first stage of labor (medians 8 and 8 in multiparous and primiparous women respectively) while satisfaction with second-stage pain management was clearly lower (respective medians 2 and 5). In a regression model satisfaction with pain management during the second stage of labor varied significantly with birthing experience. Conclusions: The childbirth experience was slightly better among multiparous than among primiparous women, although there were no significant differences regarding satisfaction with pain management according to parity during the first or second stage of labor. Satisfaction with pain relief during the second stage of labor was significantly associated with overall birthing experience.