This study is designed to determine if a differential pattern of pain is reported during the process of parturition by multiparous as compared to nulliparous women. A further aim is to investigate the relationship of selected psychologic and physiologic labor-related variables to pain reported during labor. Two hundred (150 nulliparous and 150 multiparous) married women, at term with a normal pregnancy, will serve as subjects for this descriptive, clinical study. During early (0-3cm), active (4-7cm), transitional (8-10cm), and second stage labor, the women will be asked to rate the pain of uterine contractions on the McGill Pain Questionnaire. In addition, each subject will respond to the Self-Evaluation in Labor Questionnaire during early or active labor. Cervical dilatation, frequency of uterine contractions, length of labor by phase, fetal position and fetal descent will be recorded on a continuing basis throughout labor. Additional variables include history of non-gynecologic pain, history of non-gynecologic pain, history of dysmenorrhea, prepregnancy height/weight ratio, and fetal weight. Repeated measures analysis of variance will determine if a significant main effect for parity on pain exists and if there is a significant interaction between parity and phase-of-labor. Multiple regression analysis will be used to evaluate the extent to which pain during the various phases of labor is explained by the psychologic and physiologic variables in nulliparous and multiparous women. The study findings will contribute to a more comprehensive understanding of the dynamics of the pain experience during parturition suggesting areas of intervention for more effective pain management.
