Bandura's (1977) self-efficacy theory of mastery behavior distinguishes self-efficacy expectancies from outcome expectancies. The relative roles of self-efficacy expectancies, outcome expectancies, and importance were studied as predictors of persistence of pain control in medication-free childbirth. Fifty-two primiparous women made self-efficacy judgments before and during labor and then reported in postdelivery interviews the timing and amount of medication use during labor and delivery. Self-efficacy expectancies predicted persistence in pain control without medication better than outcome expectancies, importance, and seven other alternative predictors, supporting several aspects of construct validation of the self-efficacy expectancy construct. However, self-efficacy and outcome expectancies were very highly correlated and largely redundant in their correlations with mastery. Three possible reasons and implications for the lack of differentiation of self-efficacy and outcome expectancies are discussed.