Labour Pain is a Subjective Experience. The Degree of a Woman's Suffering in Childbirth Depends on Indirect Factors

Study Overview
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Brief Summary
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Pain During Childbirth is a Complex and Subjective Experience. 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 Little Number of Studies Available. That is Why it is Necessary to Determine the Probable Factors That May Affect the Intensity of Pain.

Detailed Description
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A prospective observational study was conducted in the period from December 2020 to May 2021 at the Kyiv City Maternity Hospital №5 (Kyiv, Ukraine). The study protocol was approved by the Bogomolets National Medical University Ethics Committee. The examined predictors were derived from mothers' self-report of overall childbirth. 366 women took part in research, 282 of participants rated their pain by ≤ 60 mm visual analog scale (VAS), while 84 patients reported their pain by ≥70 mm VAS. The aim of study was to investigate predictors of severe labour pain. In the postpartum period all patients filled questionnaires and underwent interviews from the 1st to the 3rd day after delivery. The following groups of risk factors were studied: Demographic indicators (age, level of working capacity 2 months before childbirth, attendance of maternity school). General level of health (woman's level of health before childbirth, daily physical activity before childbirth, bad habits - smoking during pregnancy). Presence of mental disorders before childbirth (level of anxiety 2 weeks before childbirth, widespread muscle pain with fatigue or problems with memory, sleep, and mood). The presence of chronic pain, chronic headache or chronic back pain, the presence of rheumatoid arthritis during pregnancy, the presence of increased intracranial pressure during pregnancy. Presence of chronic intestinal diseases (irritable bowel syndrome). The level of assistance during childbirth (constant support of the doula during childbirth, the woman's ability to control pain in childbirth).

Official Title
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Predictors of Severe Labor Pain: Prospective Observational Study

Conditions
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Pain, Labor

Intervention / Treatment
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* Diagnostic Test: Visual analogue scale (VAS)
* Diagnostic Test: General anxiety scale (GAD-2) and survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mothers over 18 years of age, 1st or 2nd parturitions, childbirth with the birth of the alive fetus. Exclusion Criteria: mothers over 45 years of age, inability to obtain the informed consent of the patient or his legal representative.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Women with not severe labour pain<br>Group 1 included 282 patients (pain level ≥7 mm according to the VAS). | Diagnostic Test: Visual analogue scale (VAS)<br>* In the postpartum period all patients filled VAS and underwent interviews from the 1st to the 3rd day after delivery.<br>Diagnostic Test: General anxiety scale (GAD-2) and survey<br>* In the postpartum period all patients filled survey with GAD-2 and underwent interviews from the 1st to the 3rd day after delivery.<br>|
| Women with severe labour pain<br>Group 2 included 84 patients (pain level ≤ 6 mm using the VAS). | Diagnostic Test: Visual analogue scale (VAS)<br>* In the postpartum period all patients filled VAS and underwent interviews from the 1st to the 3rd day after delivery.<br>Diagnostic Test: General anxiety scale (GAD-2) and survey<br>* In the postpartum period all patients filled survey with GAD-2 and underwent interviews from the 1st to the 3rd day after delivery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prenatal anxiety level | Generalized Anxiety Disorder-2 scale is a tool, which confirms the diagnosis of generalized anxiety disorder. A positive Generalized Anxiety Disorder-2 scale result is a score of at least 3 points. It is considered to be negative outcome. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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labor pain, antenatal education, support by doula