Characteristics of parturients who choose to deliver without analgesia

The purpose of the study was to characterize parturients who prefer to deliver without the use of analgesia. The study population consisted of 446 consecutive low risk laboring women in early active stage of labor. Data were collected prospectively by an obstetrician, using a structured questionnaire. The degree of pain was assessed by using a visual analog scale (VAS). An obstetrician and a midwife together estimated the degree of pain as was exhibited by the parturients, using the same scale. Univariate analysis found women who undertake labor without analgesia to be significantly older, with higher birth order, of Bedouin ethnicity and to be of lower educational level than those taking analgesics during labor. Women who refused analgesia had experienced and apparently expressed lower degrees of pain (mean VAS score = 7.4 and 6.7, respectively) than those who consented to analgesia (mean VAS score = 8.6 and 8.0, respectively; p < 0.001). A multiple logistic regression model found only the severity of pain (odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.51-0.88; p = 0.004), as well as high maternal age (OR = 1.12, 95% CI 1.16-2.04; p = 0.038) to be independent factors affecting the decision not to accept analgesia during labor. In conclusion, parturients refusing analgesia were older and had experienced less pain during labor than women using analgesia.