THE INTENSITY OF LABOR PAIN IN GRAND MULTIPARAS

Background. The purpose of the current study was to investigate differ ences in pain experiences and requirements for pain control in parturi ents with different birth experience. Previous studies have shown that the labor pain experience is significantly less intense in multiparas than in primiparas and requirements for analgesic treatment have ther efore been assumed to be minimal in this group. Methods. The pain expe rience during labor was assessed by 70 consecutive grand multiparas (a minimum of five previous deliveries) compared to that of primiparous (n=70) and II-V parous women (n=70). Pain intensity was repeatedly ass essed on a pain intensity scale (0-10) according to the progress of ce rvical dilatation at the first and second stage of labor. Results. Dur ing the latent phase of cervical dilatation (0 to 3 cm) grand multipar as had a median pain score of 3 compared to 4 in II-V paras and 6 in p rimiparas (p<0.001). At the end of the first stage and during the seco nd stage the intensity of pain in grand multiparas was significantly h igher compared to that in primiparas (median scores 7 to 8 vs 6 to 7, p<0.05). Epidural blocks were administered to 40% of primiparas, 3% of II-V paras and to no grand multiparas (p<0.0001). Twenty-one percent of grand multiparas rated their pain as intolerable (pain scores 9 to 10) during the second stage compared to 10% of primiparas (p<0.05). On the third day after delivery, 47% of grand multiparas regarded their analgesia insufficient. Conclusions. The majority of parturients, incl uding grand multiparas, suffered from intense pain during labor. After delivery, a significant number of grand multiparas felt that they had received insufficient pain relief. (C) Acta Obstet Gynecol Scand 1996