Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women

Midwifery. 2015 Apr;31(4):458-63. doi: 10.1016/j.midw.2014.12.012. Epub 2015 Jan 8.


Aim: women use various labour pain management techniques during birth. The objective of this study is to investigate women׳s use of pharmacological and non-pharmacological labour pain management techniques in relation to birth outcomes.

Methods: a sub-survey of a nationally representative sample of pregnant women (n=1835) from the Australian Longitudinal Study on Women׳s Health.

Results: our analysis identified women׳s use of water for labour pain management as decreasing the likelihood of their baby being admitted to special care nursery (OR=0.42, p<0.004) whereas the use of epidural increased this likelihood (OR=3.38, p<0.001) as well as for instrumental childbirth (OR=7.27, p<0.001). Epidural and pethidine use decreased women׳s likelihood of continuing breast-feeding (ORs=0.68 and 0.59, respectively, both p<0.01) whereas the use of breathing techniques and massage for pain control increased the likelihood of women continuing breast-feeding (ORs=1.72 and 1.62, respectively, both p<0.01).

Conclusions: our study illustrates associations between the use of both pharmacological and non-pharmacological labour pain management techniques and selected birth outcomes while controlling for confounding variables. There remain significant gaps in the evidence base for the use of non-pharmacological labour pain control methods and our findings provide a platform with which to develop a broad clinical research programme around this topic.

Keywords: Childbirth; Infant health; Labour pain; Pain management; Pregnancy outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Analgesia / statistics & numerical data
  • Adult
  • Analgesia, Epidural / statistics & numerical data
  • Analgesia, Obstetrical / methods*
  • Analgesia, Obstetrical / statistics & numerical data
  • Analgesics / administration & dosage
  • Analgesics / therapeutic use*
  • Australia
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Infant Health / standards
  • Infant, Newborn
  • Labor Pain / drug therapy*
  • Labor Pain / therapy*
  • Longitudinal Studies
  • Massage / statistics & numerical data
  • Maternal Health / standards
  • Obstetric Labor Complications / drug therapy
  • Obstetric Labor Complications / prevention & control*
  • Obstetric Labor Complications / therapy
  • Pain Management / methods*
  • Pregnancy
  • Treatment Outcome


  • Analgesics
  • Fentanyl