Document Type : Original Article

Authors

1 Department of Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences

2 Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences,

3 Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

INTRODUCTION: Factors affecting labor pain include physiological, psychological, and social factors,
among which psychological factors refer to attitudes and beliefs about labor pain. Hence, the present
study was conducted to determine the relationship between attitude toward labor pain and length of
the first, second, and third stages in primigravida women.
MATERIALS AND METHODS: This cross‑sectional study was performed on 230 pregnant
women who were referred to hospitals affiliated to Isfahan University of Medical Sciences in a
two‑stage sampling in 2018. In the beginning, the participants completed the questionnaire of
demographic/fertility characteristics and attitude to labor pain (25Q), and at the next stage, the
researcher completed the form of labor information including length of the labor stages. Data were
analyzed by SPSS software version 22 and Pearson correlation coefficient, Student’s t‑test, one‑way
ANOVA, and general linear regression.
RESULTS: The mean (standard deviation) of the attitude to labor pain was 53.96 (1.9), and the
length of the first stage was 10.01 (0.3) (h), the second stage was 1.6 (0.4) (h), and the third stage
was 15.9 (1.7) (min). One hundred and eighty‑three (79.6%) had negative attitude and 47 (20.4%)
had positive attitude toward labor pain. There was a significant positive correlation between attitude
toward labor pain and length of the first (P = 0.001, r = 0.37) and second stages of labor (P = 0.001,
r = 0.24).   There was no significant between length of third stage of labor and attitude toward labor
pain (P = 714).
CONCLUSION: The results showed that the majority of primiparous women had a higher (negative)
attitude toward labor pain, which was associated with  longe the first and second stages of labor.

Keywords

1. Umeorac J, Ukkaegbe OU, Eze CI, Masekoameng JN, Kelly A.
Spousal companionship in labor in an urban Facility in South
East Nigeria. Anatolian J Obstet Gynecol 2011;2:1‑5.
2. Rouhe H, Salmela‑Aro K, Gissler M, Halmesmäki E, Saisto T.
Mental health problems common in women with fear of
childbirth. BJOG 2011;118:1104‑11.
3. Fariba A, Alireza A, Shirin T, Ali DN, Leila SM, Roghaieh R.
Maternal women’s experience: A phenomenological study.
J Gonabad Univ Med Sci Health Serv 2009;15:47‑39.
4. Lowder Milk DL, Perry SE, Cashion K. Maternity Nursing. 8th ed.
Maryland: Mosby; 2014.
5. Sousan H, Mahrokh D, Mahin KF, Morteza G. Comparison of
severity of labor pain and factors affecting its perception in
primiparous and multiparous women in private and public
nursing homes. Med J Tabriz Univ Med Sci 1391;34:117‑21.
6. Best S. The social construction of pain: An evaluation. Disabil Soc
2007;22:71‑161.
7. Etowa JB. Becoming a mother: The meaning of childbirth for
African‑Canadian women. Contemp Nurse 2012;41:28‑40.
8. Stoll K, Hall W, Janssen P, Carty E. Why are young Canadians
afraid of birth? A survey study of childbirth fear and birth
preferences among Canadian university students. Midwifery
2014;30:220‑6.
9. Schwartz JA. Childbirth as a Profound Experience: Exploring
Narrative and Image of Experiences during Birth. San Francisco,
CA: California Institute of Integral Studies; 2014. p. 85.
10. Homa S, Al‑Zamani Sayeh Sadat MS, Fereshteh J, Leila NS,
Hamid H. A survey on the relationship between perceived
support in first pregnancy and satisfaction with delivery in
women referred to Shahid Akbar Abadi Medical Education Center
in Tehran. J Prev Care Nurs Midwifery 1393;4:64‑54.
11. ParvinY, Ziba T, AbbasE, Maryam G. Iranian women’s perception
of labor pain. J Armageddon J Yasuj Univ Med Sci 1396;22:270‑55.
12. Monavareh A, Esmat N, Maein K. Jnvestigatigating attitude of
labor pain and choosing the type of delivery in pregnant women
referring to health centers in Kerman. J Nurs Midwifery Kerman
2011;10;36‑41.
13. Elvander C, Cnattingius S, Kjerulff, K. Birth experience in women
with low, intermediate or high levels of fear: findings from the
first baby study. Birth, 2013; 40 (4): 289‑296.
14. Marjan AS, Masoumeh BN, Tahereh T. Explain the role of
women’s labor experiences in choosing the type of delivery.
J Obstet Gynecol Fac Urmia 2014;12:286‑96.
15. Sharifirad G, Fathian Z, Tirani M, Mohleki B. The attiude
of pregnant women toward vaginal delivery and cesarian
section based on intention behavoural model. J Reprod Infertil
2012;13:237‑40.
16. Lowe NK. The pain and discomfort of labor and birth. J Obstet
Gynecol Neonatal Nurs 1996;25:82‑92.
17. Latifnejad Roudsari R, Zakerihamidi M, Merghati Khoei E,
Kazemnejad A. Comparing the cultural beliefs related to mode
of delivery among pregnant women and women with childbirth
experiences as vaginal delivery or cesarean section (Tonekabon,
2014). JMUMS 2015;24:54‑68.
18. Haines HM, Rubertsson C, Pallant JF, Hildingsson I. The influence
of womens fear, attitudes and beliefs of childbirth on mode and
experience of birth. BMC Pregnancy and Childbirth2012;12 (55):1‑14.
19. Green J, Couplland V, Kitzinger S; National Institute for Health
and Clinical Excellence: Intrapartum Care of Healthy Women
and their Babies during Childbirth. Expectations, experiences,
and psychological outcomes of childbirth: A prospective study
of 825 women. Birth 2011;17:15‑24.
20. Fraset DM, Cooper MA. Myles Textbook for Midwives. 15th ed.
Edinburgh: Churchill Livingstone; 2008. p. 434‑5.
21. Shahali SH, Kashanian M. Effect of acupressure at the sanyinjiao
point (SP6) on the process of active phase of labor pain in
Nulliparas women. J Babol Univ Med Sci 2010;2:7‑11.
22. Fahimeh SS, Samayeh K, Morteza G. Comparison of the mean
duration of delivery stages in primiparous women. Iran J Obstet
Gynecol Infertil 1394;18:18‑25.
23. Roberts L, Gulliver B, Fisher J, Cloyes RG. The coping with labor
algorithm: Analternate pain assessment tool for the laboring
woman. J Midwifery Women Health 2010;2:107‑17.
24. Vedadhir AH, Sadati M, Taghavi S. Childbearing as a
socio‑cultural problem: Construct realistic reflection of ceszrean
section in Tabriz. Anthropol Res Iran 2012;2:111‑35.
25. Ternstrom E, Hildingsson I, Haines H, Rubertsson C. Pregnant
womens thoughts when assessing fear of birth on the fear of birth
scale. Women Birth 2016;29:44‑9.
26. Johnson TR, Callister LC, Freeborn DS, Beckstrand RL,
Huender K. Dutch women’s perceptions of childbirth in the
Netherlands. MCN Am J Matern Child Nurs 2007;32:170‑7.
27. Callister LC, Holt ST, Kuhre MW. Giving birth: The voices of
Australian women. J Perinat Neonatal Nurs 2010;24:128‑36.
28. Moeini B, Besharati F, Hazavehei SM, Moghimbeigi A. Womens
attitudes toward elective delivery mode based on the theory of
planned behavior. MOEINI, B., et al. Journal of Guilan university
of medical sciences 2011; 20 (79):68‑76.
29. Sharifi Rad GR, Fathian Z, Tirani M, Mahaki B. Study on
behavioral intention model (BIM) to the attitude of pregnant
women toward normal delivery and cesarean section in province
of Esfahan – Khomeiny Shahr‑2006. J Ilam Univ Med Sci
2007;15:19‑23.
30. Yarandy F, Rezaie Z, Eftekhar Z, Saadat H, Ansari Jafari M.
Knowledge and attitude of pregnant women to methods of birth
in patients referred to health centers in Tehran in 1999. J Med Fac
Guilan Univ 2003;1:15‑21.
31. Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of
women’s perceptions of the childbirth experience. J Obstet
Gynecol Neonatal Nurs 2008;37:24‑34.