Women's preferences and received pain relief in childbirth – A prospective longitudinal study in a northern region of Sweden

• Women's preferences for pain relief are met to a large extent.
• Preferences for pharmacological methods are met to a greater extent compared to non-pharmacological methods.
• Preferences and primiparity are factors strongly associated with the use of certain pain relief methods.
• Epidural is associated with a less positive birth experience, regardless of preference.

BackgroundA range of alternatives in pain management during childbirth are available in the western countries. Women's preferences for and use of pain relief methods during labour is not fully investigated. The aim of this study was to describe what pain relief methods pregnant women preferred when asked in late pregnancy and to identify factors associated with preferred and received pain relief methods.MethodsA prospective longitudinal study in a northern region of Sweden (n = 936). Data were collected by three questionnaires. Odds ratios with a 95% confidence interval were calculated between preferred and received pain relief methods for several explanatory variables.FindingsThe most preferred pain relief methods were also the most common received pain relief methods; nitrous oxide, bathing, breathing techniques, epidural analgesia and massage. The strongest factors for using different pain relief methods were primiparity and preferences. Women who used epidural analgesia, regardless of preference, were two to four times more likely to have a less positive birth experience.ConclusionsWomen's preferences for a certain pain relief method were largely met. Greater differences were seen between background factors and preferences than the received pain relief methods. Preferences and primiparity were the most important factors for actually using pain relief. Epidural analgesia was associated with a less positive birth experience.