Severe recalled labour pain and elective cesarean section in a
subsequent delivery: A population-based, longitudinal study
Abstract
Objective To assess the impact of severe recalled labour pain from the
previous birth on the preference and delivery of an elective cesarean
section (CS) in the subsequent delivery. Design A population-based,
longitudinal study. Setting Akershus University Hospital, Norway.
Population In total, 1,244 parous women recruited during routine fetal
ultrasound examination at the 17th week of pregnancy between November
2008 and April 2010 were included. Methods Logistic regression analyses
were conducted with data gathered from two questionnaires at 17th and
32nd week of pregnancy and electronic birth records. Main Outcome
Measures Preference of an elective CS and actual delivery by elective
CS. Results Recalled severe labour pain at the previous birth was
associated with a preference of an elective CS (crude OR 2.11, 95% CI
1.43-3.12) and actual delivery by elective CS (crude OR 1.70, 95% CI
1.04-2.77). This association remained statistically significant for both
preference of (adjusted OR 1.75, 95% CI 1.10-2.77) and delivery by
elective CS (adjusted OR 1.95, 95% CI 1.03-3.66) when adjusting for
years passed since previous birth, birth method, epidural anesthesia,
overall birth experience, and fear of childbirth. Conclusions Women with
severe recalled labour pain were about twice as likely to prefer or
deliver by elective CS as women without severe recalled pain.
Irrespective of severe recalled labour pain, preference for elective CS
was statistically significantly associated with actual delivery by
elective CS. Funding Research Council of Norway (project number 191098)
Keywords Elective cesarean section, recalled labour pain, preference,
delivery, previous birth experience