Author(s): Anastasiia Romanenko* and Iurii Kuchyn
Introduction: Pain during childbirth is a subjective experience that every mother experiences differently. The degree of a woman's suffering in childbirth depends on the intensity of labour pain and many indirect factors. Complex interrelated effects on labour pain are limited by the small number of studies available. That is why it is necessary to determine the probable factors that may affect the intensity of pain. In accordance with this, determining predictors of the intensity of women’s pain during vaginal delivery remains an important issue for maternity health policy.
Aim: Investigate predictors of severe labour pain.
Method: A prospective observational study was conducted in the period from December 2020 to May 2021 at the Kyiv City Maternity Hospital №5 (Kyiv, Ukraine). Univariate and multivariate logistic regression were used to measure the influence of risk factors on the probability of severe labour pain.
Results: The examined predictors were derived from mothers` self-report of overall childbirth. 366 women took part in research, 282 of them rated their pain by ≤ 70 mm visual analog scale (VAS), while 84 patients reported their pain by ≥ 60 mm VAS. The study identified predictors that reduce the risk of severe labour pain, such as a second delivery (OR 0.60 [95% CI 0.37–0.98], p=0,04), a woman's prenatal health (namely, a healthy prenatal woman) (OR 0.16 [95% CI 0.07–0.37], p<0.001), attendance of antenatal classes (OR 0.09 [95% CI 0.05–0.17)], p<0.001), the constant doula`s help (OR 0, 21 [95% CІ 0.12 – 0.36], p<0.001) and feeling of control over pain in labour (OR 0,05 [95% CІ 0.03–0.09], p<<0.001). In addition, predictors such as and presence of general anxiety disorder in contrast to the factors listed above, increase the risk of severe labour pain (OR 5.63 [95% CI 3.33–9.51], p<0.001).
Conclusion: These studies scientifically substantiate the importance of prenatal screening of the mental state of pregnant women and antenatal education. Our Ukrainian research suggests women, medical team and doulas should be involved in care in labour and in shared decision making for improving health outcomes.