Maternal Pain Research Articles

Effect of various techniques of Anesthesia in elective Caesarian section on short term Neonatal outcome

Introduction: The basic aim of obstetric anesthesia is to provide adequate maternal pain relief with no deleterious effect on mother and newborn. This study aimed to assess the effect of spinal anesthesia, epidural anesthesia and general anesthesia using thiopentone sodium as induction agent on neonates delivered after elective caesarian section. Materials and methods: This is a prospective descriptive study at a tertiary care teaching hospital from June 2013 to May 2014. 60 cases of elective caesarian section admitted in Department of Obstetrics and Gynecology were studied. Patients were randomly divided into 3 groups each of 20 cases. Group 1 received spinal anesthesia, group 2 epidural anesthesia and group 3 general anesthesia. Neonatal outcome was assessed in relation to anesthetic techniques used. Results: The mean Apgar score at 1 min was lower in GA group (7 +/- 1.025) than in spinal anesthesia group (8.1+/- 0.78) and epidural anesthesia group (8.35 +/- 0.745). Total 3/60 (5%) neonates required resuscitation at birth all of which were in GA group. Induction delivery interval of 20 min was associated with need for resuscitation at birth. Moderate depression of neonates (1 min Apgar score of 4-6) was observed in 2/20 (10%) neonates in group 3. Conclusion: Neonates born by elective LSCS under GA have lower 1 min Apgar scores. Induction delivery interval of 20 min is associated with need for resuscitation at birth in neonates in GA group. These effects can be minimized by maintaining the ID interval between 5 – 15 minutes.

Neck/upper back and low back pain in parents and their adult offspring: Family linkage data from the Norwegian HUNT Study.

Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. This study examined the intergenerational association of spinal pain using data from 11,081 parent-offspring trios participating in the population-based HUNT Study in Norway. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for offspring spinal pain associated with parental spinal pain. In total, 3654 (33%) offspring reported spinal pain at participation. Maternal and paternal spinal pain was consistently associated with higher ORs for offspring spinal pain. The results suggest a slightly stronger association for parental multilevel spinal pain (i.e., both neck/upper back pain and low back pain) than for pain localized to the neck/upper back or low back. Multilevel spinal pain in both parents was associated with ORs of 2.6 (95% CI, 2.1-3.3), 2.4 (95% CI, 1.9-3.1) and 3.1 (95% CI, 2.2-4.4) for offspring neck/upper back, low back and multilevel spinal pain, respectively. Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain.

Influence of birth ball and free position in psychological status, labor pain and birth control sence of pregnant women

Objective To investigate influence of birth ball and free position in psychological status , labor pain and birth control sence of pregnant women.Methods In our hospital from October 2011 to December 2013 , 208 pregnant women were selected who accepted natural childbirth.Pregnant women were randomly divided into two groups.104 pregnant women were treated with traditional supine or semire-cumbent position during pregnancy and delivery as control group.104 pregnant women were treated with birth ball and free position as obser-vation group.Anxiety was evaluated by Hamilton Anxiety Scale （ HAMA ） .Depression was evaluated by Hamilton Depression Scale （ HAMD） .Pain was evaluated by Visual Analogue Scale （ VAS ） .Birth control sence was evaluated by Labor Agentry Scale （ LAS ）.Psychological status , labor pain, birth control sence and delivery outcome were compared between two groups.Results After delivery, HA-MA score and HAMD score decreased significantly in two groups.HAMA score, HAMD score, VAS score in observation group were signifi-cantly lower than those in the control group.LAS score in observation group was significantly higher than that in the control group.First stage of labor, second stage of labor, third stage of labor, total labor, postpartum 2h bleeding volume in observation group were significantly less than those in the control group.Differences were statistically significant （ P〈0.05 ） .Conclusions Birth ball and free position can signifi-cantly improve psychological status of pregnant women , significantly reduce maternal pain and improve birth control sence.That is worthy of clinical use. Key words: Birth ball; Free position; Psychological status; Labor pain; Birth control sence

Clinical application effect of Lamaze breathing in obstetrics

Objective To explore the Lamaze application effect of reducing pain in childbirth in the stages of breathing.Methods 158 cases of healthy check-up natural birth mothers according to digital table method were randomly divided into two groups,control group with 79 cases were given routine nursing labor treatment; observation group with 79 cases on the basis of the control group was given Lamaze breathing with childbirth intrapartum implement high quality nursing intervention; and compare the effect of the two groups.Results The postpartum hemorrhage in observation group was obviously lower than that of the control group (P＜ 0.05); observation group of the first,the second labor and labor primipara total labor significantly shortened than the control group (all P ＜ 0.05),the nature of the observation group births and neonatal 1 min Apgar score compared with control group (P ＞ 0.05); comfortable satisfaction of the 98.73％ in observation group was obviously higher than that of control group 87.34％ (P ＜ 0.05); the level of anxiety in the maternal pain and observation group were significantly lower than those of control group (all P ＜ 0.05); birth control in observation group was significantly higher than that of control group (P ＜ 0.05).Conclusion Lamaze guidance maternal pain childbirth breathing,can obviously relieve maternal adverse emotions such as anxiety,reduce maternal childbirth pain,shorten the labor,can effectively improve the natural births,reduce the cesarean section rate of maternal,which is a simple,safe,economic,reliable and convenient method with non-drug pain relief delivery. Key words: Primipara; Lamaze breathing; Pain; Vaginal births; Cesarean delivery rate

Balance in Opioid Prescription during Pregnancy

Balance in Opioid Prescription during Pregnancy

Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review

In modern obstetrics, different pharmacological and non-pharmacological options allow to obtain pain relief during labour, one of the most important goals in women satisfaction about medical care. The aim of this review is to compare all the analgesia administration schemes in terms of effectiveness in pain relief, length of labour, mode of delivery, side effects and neonatal outcomes. A systematic literature search was conducted in electronic databases in the interval time between January 1999 and March 2013. Key search terms included: “labour analgesia”, “epidural anaesthesia during labour” (excluding anaesthesia for Caesarean section), “epidural analgesia and labour outcome” and “intra-thecal analgesia”. 10,331 patients were analysed: 5,578 patients underwent Epidural-Analgesia, 259 patients spinal analgesia, 2,724 combined spinal epidural analgesia, 322 continuous epidural infusion (CEI), 168 intermittent epidural bolus, 684 patient-controlled infusion epidural analgesia and 152 intra-venous patient-controlled epidural analgesia. We also considered 341 women who underwent patient-controlled infusion epidural analgesia in association with CEI and 103 patients who underwent patient-controlled infusion epidural analgesia in association with automatic mandatory bolus. No significant differences occurred among all the available administration schemes of neuraxial analgesia. In absence of obstetrical contraindication, neuraxial analgesia has to be considered as the gold standard in obtaining maternal pain relief during labour. The options available in the administration of analgesia should be known and evaluated together by both gynaecologists and anaesthesiologists to choose the best personalized scheme and obtain the best women satisfaction. Since it is difficult to identify comparable circumstances during labour, it is complicate to standardize drugs schemes and their combinations.

Prenatal effects of buspirone and stress on behavioral reactions in rat pups of different sexes during period of ontogeny with low level of brain serotonin

Previously we revealed for the first time pain response exacerbation caused by inflammation in rats born to dams exposed to stress during pregnancy (prenatal stress). The present study is devoted to tinvestigation of prenatal stress effects on psychoemotional and tonic pain reactions in rat pups during the individual development period that is characterized with a dramatic reduction of the brain serotonin level. Effects of maternal buspirone before stress during pregnancy on functional indices of psychoemotional and tonic pain systems in the offspring were also investigated. Prenatal stress increased the number of pain patterns (flexing + shaking) during different phases of the time-course of formalin-induced pain in females and males to a greater extent in males. Prenatlly stressed rat pups of both sexes failed to show reliable changes in the index of psychoemotional behavior in the forced swim test. With the aim to decrease pain response exacerbation found in prenatally stressed offspring, pregnant dams were exposed to chronic injections of serotoninergic anxiolytic and antidepressant buspirone which is an agonist of 5-HT1A receptors; prenatal effect of buspirone on psychoemotional behavior in prenatally stressed rat pups was also evaluated. Maternal buspirone normalized pain behavior and decreased considerably the time of immobility, the index of depressive behavior in the forced swim test. The present results indicate analgesic and antidepressive effects of maternal buspirone in prenatally stressed 10-day old rat pups and demonstrate sexual dimorphism in effects of prenatal stress on the time-course of formalin-induced pain. Differences in effects of prenatal influences on pain respone during the interphase in males and females indicate earlier maturation of the descending serotonergic inhibitory system of afferent pain signals modulation in males than in females and demonstrate that 5-HT1A receptors are involved in this process.

Long-Term Sequelae of Emotional Parentification: A Cross-Validation Study Using Sequences of Regressions

The aim of our study was the analysis of long-term sequelae of emotional parentification in childhood. Two samples (n = 500 each) were examined via the internet regarding parentification and perceived love in childhood, as well as other childhood experiences such as abuse, having been raised by a single parent and parental loss, as well as adult depressive and vegetative symptoms and pain. A questionnaire set containing 280 items was filled out. Emotional parentification in childhood, maternal as well as paternal, was found to be a strong predictor of depression in adulthood. Indicators of somatization showed associations in the same direction, but these were much weaker. Also, associations between paternal parentification and vegetative symptoms, as well as between maternal parentification and pain in adulthood could be observed. Perceived love from the father during childhood was one of the protective factors for development of various problems in adult life. The results indicate the necessity of directing more attention, both clinically and empirically, towards emotional parentification.

Birth-related, psychosocial, and emotional correlates of positive maternal–infant bonding in a cohort of first-time mothers

Objectiveto describe the development of a shortened 10-item version of the Postpartum Bonding Questionnaire (S-PBQ) and examine the relationship between birth-related, psychosocial, and emotional factors and maternal–infant bonding. Designcross-sectional interview study. Settingwomen having their first baby in Pennsylvania, USA. Participantswe interviewed 3005 women in their third trimester and at one month post partum who were enroled in the First Baby Study. Measurements and findingsfor the S-PBQ, we completed factor analysis and examined instrument properties. We examined the relationship between birth-related, psychosocial, and emotional factors and maternal–infant bonding using adjusted linear regression models. The S-PBQ demonstrated acceptable internal reliability (Cronbach׳s α=0.67). Analysis revealed a socio-economic bias such that women who were older, more educated, not living in poverty, and married reported lower bonding scores. Maternal–infant bonding was significantly negatively correlated with maternal stress, maternal pain, and post partum depression, and positively correlated with partner support with the infant, and social support. Key conclusions and implications for practiceFor researchers who wish to measure maternal–infant bonding but are in need of a relatively short scale, the 10 item S-PBQ may be a useful alternative to the original version. However, it is important that researchers measuring maternal–infant bonding also investigate socio-economic bias in their studies and adjust for this effect as needed. Our results also indicate that clinicians should be aware of life stressors that may impact the maternal–infant relationship, in order that intervention may be provided to improved health outcomes for mothers, infants, and families.

Betamimetics for inhibiting preterm labour.

Preterm birth is a major contributor to perinatal mortality and morbidity worldwide. Tocolytic agents are drugs used to inhibit uterine contractions. Betamimetics are tocolytic agents that have been widely used, especially in resource-poor countries. To assess the effects of betamimetics given to women with preterm labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2013) and reference lists of retrieved studies. Randomised controlled trials of betamimetics, administered by any route or any dose, in the treatment of women in preterm labour where betamimetics were compared with other betamimetics, placebo or no treatment. Two review authors assessed risk of bias and extracted the data independently. Twenty-eight trials were assessed as eligible for inclusion in the review, but eight did not report any outcome data relevant to the review. Results are based on the 20 trials that contributed data.Twelve trials, involving 1367 women, compared betamimetics with placebo. Betamimetics decreased the number of women in preterm labour giving birth within 48 hours (average risk ratio (RR) 0.68, 95% confidence interval (CI) 0.53 to 0.88, 10 trials, 1209 women). There was a decrease in the number of births within seven days (average RR 0.80; 95% CI 0.65 to 0.98, five trials, 911 women) but there was no evidence of a reduction in preterm birth (before 37 weeks' gestation) (RR 0.95; 95% CI 0.88 to 1.03, 10 trials, 1212 women). No benefit was demonstrated for betamimetics for perinatal death (RR 0.84; 95% CI 0.46 to 1.55, 11 trials, 1332 infants), or neonatal death (RR 0.90; 95% CI 0.27 to 3.00, six trials, 1174 infants). No significant effect was demonstrated for respiratory distress syndrome (RR 0.87; 95% CI 0.71 to 1.08, eight trials, 1239 infants). A few trials reported on cerebral palsy, infant death and necrotising enterocolitis; no significant differences between groups were identified for any of these outcomes. Betamimetics were significantly associated with the following outcomes: withdrawal from treatment due to adverse effects; maternal chest pain; dyspnoea; palpitation; tremor; headaches; hypokalaemia; hyperglycaemia; nausea or vomiting; nasal stuffiness; and fetal tachycardia.Nine trials compared different types of betamimetics. Other betamimetics were compared with ritodrine in five trials (n = 948). Other comparisons were examined in single trials: hexoprenaline compared with salbutamol (n = 140), slow versus moderate release salbutamol (n = 52) and salbutamol compared with terbutaline (n = 200). Trials were small, varied, and of insufficient quality to delineate any consistent patterns of effect. Betamimetics help to delay birth, which may give time to allow women to be transferred to tertiary care or to complete a course of antenatal corticosteroids. However, multiple adverse effects must be considered. The data are too few to support the use of any particular betamimetic.

Efektivitas Perlakuan Pijat Effleurage pada Kala I Fase Aktif Persalinan untuk Mengurangi Rasa Nyeri pada Ibu Bersalin di BPM Yusnaeni Bulan Mei Tahun 2013

Background : At the first active phase is currently the most tiring and heavy. In this phase, most women feel intense pain due to uterine activity began to be more active. Increasing number of women who want to give birth with the birth process that takes place without pain cause a variety of methods are used to reduce pain in childbirth. The most frequently performed to reduce pain is to massage method. But sometimes the method of massage that is done not in place so that the result is inefficient.
 Objectives : To examine the effectiveness of effleurage massage treatment at the first stage of the active phase of labor to reduce maternal pain in BPM Yusnaeni.
 Methods : The study was a Quasi Experiment with One Group Pre-test Post-test. Respondents in this study were all mothers delivered at the first stage of the active phase in the BPM Yusnaeni by the number of study subjects were 10 mothers were taken by way of Non-Probability sampling technique with saturated.
 Results : Statistical test Wilcoxon Signed Ranks Test showed Ztest at -2,873 with Zstaistic value for (p <0.05) is equal to -1.96. From the results of calculations using the Wilcoxon Signed Ranks Test is also known that Ztest> Zstatistic (-2,873> -1.96). It means that Ho is rejected or there is a difference of pain before and after the effleurage massage.
 Conclusion: There is a massage treatment effectiveness eflleurage the first stage of labor to reduce maternal pain

Women's choice of positions during labour: return to the past or a modern way to give birth? A cohort study in Italy.

Background. Childbirth medicalization has reduced the parturient's opportunity to labour and deliver in a spontaneous position, constricting her to assume the recumbent one. The aim of the study was to compare recumbent and alternative positions in terms of labour process, type of delivery, neonatal wellbeing, and intrapartum fetal head rotation. Methods. We conducted an observational cohort study on women at pregnancy term. Primiparous women with physiological pregnancies and single cephalic fetuses were eligible for the study. We considered data about maternal-general characteristics, labour process, type of delivery, and neonatal wellbeing at birth. Patients were divided into two groups: Group-A if they spent more than 50% of labour in a recumbent position and Group-B when in alternative ones. Results. 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. No differences were found in terms of neonatal outcomes. Conclusion. Alternative maternal positioning may positively influence labour process reducing maternal pain, operative vaginal delivery, caesarean section, and episiotomy rate. Women should be encouraged to move and deliver in the most comfortable position.

Evidence of Improved Milk Intake After Frenotomy: A Case Report

Ankyloglossia (tongue tie) is a well-recognized cause of breastfeeding difficulties and, if untreated, can cause maternal nipple pain and trauma, ineffective feeding, and poor infant weight gain. In some cases, this condition will result in a downregulation of the maternal milk supply. Milk-production measurements (24-hour) for a breastfeeding infant with ankyloglossia revealed the ineffective feeding of the infant (78 mL/24 hours), and a low milk supply (350 mL/24 hours) was diagnosed. Appropriate management increased milk supply (1254 mL/24 hours) but not infant milk intake (190 mL/24 hours). Test weighing convincingly revealed the efficacy of frenotomy, increasing breastfeeding milk transfer from 190 to 810 mL/24 hours. Postfrenotomy, breastfeeding almost completely replaced bottle-feeding of expressed breast milk. This case study confirms that ankyloglossia may reduce maternal milk supply and that frenotomy can improve milk removal by the infant. Milk-production measurements (24-hour) provided the evidence to confirm these findings.

Local anesthesia and pain perception during amniocentesis: a randomized double blind placebo‐controlled trial

To determine the effect of local anesthesia on the maternal pain perception from amniocentesis. We conducted a randomized double blind placebo controlled trial comparing use of local anesthesia (1% lidocaine) with placebo with regards to maternal perception of pain among women undergoing genetic amniocentesis. The primary outcome was the intensity of perceived maternal pain as measured by the Visual Analogue Scale (VAS) as well a 101 point Numerical Rating Scale. Seventy six women participated in the trial. 36 (47.4%) women were randomized to lidocaine, whereas 40 (52.6%) were randomized to placebo. There were no statistically significant differences between the groups in terms of baseline sociodemographic and clinical characteristics. However, pain perception as characterized by the median 9.5 (2.1-21.0) VSA scores was significantly lower among women in the lidocaine group compared with among women in the placebo group [18.4 (12.9-31.3), P = 0.005]. Similarly the mean VSA scores was significantly lower in the lidocaine group (P = 0.02). A trend toward lower scores was also observed when maternal pain perception was measured by the Numerical Rating Scale. Local anesthetic lidocaine significantly lowers maternal perceived pain during genetic amniocentesis.

Comparison of the Leboyer Childbirth Method with Normal Vaginal Delivery: Mothers' Perception of Childbirth Experience, Labor Pain, Newborn's Pain Response and Maternal Attachment Behaviors

Objectives: The Leboyer childbirth method is known as less stressful and humane delivery method for both mothers and newborns. The objectives of this study was to compare the Leboyer childbirth method with normal vaginal delivery in terms of mothers perception of the childbirth expe ’ rience, labor pain, newborn's pain response and maternal attachment behaviors. Materials and Methods: Sample of this study included forty one mothers in the Leboyer group and thirty three normal delivery mothers from two women's hospitals during the period of 28th February to 15th April 2010. All mothers completed questionnaires including the Marut and Mercer's perception of childbirth experience, 0~10 numeric scale of labor pain, Lawrence's newborn pain response, and Cropley, Lester, Pennington's maternal attachment behaviors. Results: The findings indicated significantly higher scores for mothers with the Leboyer method ’ of childbirth on the Perception of Childbirth Experience (t=7.47, p<.001) and on maternal attachment behaviors (t=10.39, p<.001) and lower scores on maternal post-labor pain (t=-2.51, p= .014) as well as on the newborn's pain (t=-5.15, p<.001). There were no significant differences between the two groups for pre-labor pain. Conclusion: Mothers with Leboyer childbirth method reported more positive maternal childbirth experiences, maternal attachment behavior, and less newborn's pain response and less post-labor pain than mothers in the comparison group with the exception of pre-labor pain.

Expansion Abdominoplasty for a Pregnant Woman With Severe Abdominal Wall Contracture due to a Major Burn During Childhood

Normal abdominal expansion that occurs as a result of hormonal actions during pregnancy may be prevented by the presence of excessive scar tissue in individuals who have received severe burns. In these instances, the lack of abdominal expansion may cause maternal pain and put the infant at risk. A 23-year-old pregnant woman presented with severe abdominal wall contracture due to a major burn sustained during childhood. At 20 weeks of pregnancy, expansion abdominoplasty, consisting of zigzag incisions in the fascia to release the contracture and a split-thickness skin graft, was performed. The patient gave birth, via a planned cesarean operation at 36 weeks of pregnancy, to a baby girl in good condition; the postpartum course was uneventful.

PM.73 Case Report: Abdominal Cutaneous Nerve Entrapment Syndrome in the Pregnant Patient

Case ReportA 25 yr para 1 (NVD) at 30 + 2 weeks gestation presented with severe right sided abdominal pain. Vital signs were stable. Tenderness was elicited in the right...

Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants: a randomized trial

BackgroundInfants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding. Healthy newborns experiencing skin-to-skin contact at birth are pre-programmed to find the mother’s breast. This study investigates if skin-to-skin contact between mothers with older infants having severe latching on problems would resolve the problem.MethodsMother-infant pairs with severe latch-on problems, that were not resolved during screening procedures at two maternity hospitals in Stockholm 1998–2004, were randomly assigned to skin-to-skin contact (experimental group) or not (control group) during breastfeeding. Breastfeeding counseling was given to both groups according to a standard model. Participants were unaware of their treatment group. Objectives were to compare treatment groups concerning the proportion of infants regularly latching on, the time from intervention to regular latching on and maternal emotions and pain before and during breastfeeding.ResultsOn hundred and three mother-infant pairs with severe latch-on problems 1–16 weeks postpartum were randomly assigned and analyzed. There was no significant difference between the groups in the proportion of infants starting regular latching-on (75% experimental group, vs. 86% control group). Experimental group infants, who latched on, had a significantly shorter median time from start of intervention to regular latching on than control infants, 2.0 weeks (Q1 = 1.0, Q3 = 3.7) vs. 4.7 weeks (Q1 = 2.0, Q3 = 8.0), (p-value = 0.020). However, more infants in the experimental group (94%), with a history of “strong reaction” during “hands-on latch intervention”, latched-on within 3 weeks compared to 33% in the control infants (Fisher Exact test p-value = 0.0001). Mothers in the experimental group (n = 53) had a more positive breastfeeding experience according to the Breastfeeding Emotional Scale during the intervention than mothers in the control group (n = 50) (p-value = 0.022).ConclusionsSkin-to-skin contact during breastfeeding seems to immediately enhance maternal positive feelings and shorten the time it takes to resolve severe latch-on problems in the infants who started to latch. An underlying mechanism may be that skin-to-skin contact with the mother during breastfeeding may calm infants with earlier strong reaction to “hands on latch intervention” and relieve the stress which may have blocked the infant’s inborn biological program to find the breast and latch on.Trial registrationKarolinska Clinical Trial Registration number CT20100055

Sex differences in the relationship between maternal fear of pain and children&amp;#39;s conditioned pain modulation

BackgroundParental behaviors, emotions, and cognitions are known to influence children’s response to pain. However, prior work has not tested the association between maternal psychological factors and children’s responses to a conditioned pain modulation (CPM) task. CPM refers to the reduction in perceived pain intensity for a test stimulus following application of a conditioning stimulus to a remote area of the body, and is thought to reflect the descending inhibition of nociceptive signals.MethodsThe present study examined sex differences in the association between maternal anxiety about pain and children’s CPM responses in 133 healthy children aged 8–17 years. Maternal pain anxiety was assessed using the Pain Anxiety Symptoms Scale-20. In addition to the magnitude of CPM, children’s anticipatory anxiety and pain-related fear of the CPM task were measured.ResultsSequential multiple linear regression revealed that even after controlling for child age and general maternal psychological distress, greater maternal pain anxiety was significantly related to greater CPM anticipatory anxiety and pain-related fear in girls, and to less CPM (ie, less pain inhibition) in boys.ConclusionThe findings indicate sex-specific relationships between maternal pain anxiety and children’s responses to a CPM task over and above that accounted for by the age of the child and the mother’s general psychological distress.

Maternal experience of musculoskeletal pain during pregnancy and birth outcomes: Significance of lower back and pelvic pain

Aimto examine the association between back and pelvic pain during pregnancy and birth outcomes. Backgroundback and pelvic pain during pregnancy is a common occurrence. It is known to affect maternal functioning and well-being during pregnancy and can persist postnatally and beyond. However, there has been little examination of the impact upon birth outcomes such as birth mode, duration of labour and pain experience. Methodfive hundred and eighty mothers with an infant aged zero to six months completed a retrospective questionnaire documenting their pain during pregnancy and birth outcomes (e.g. mode, duration, interventions, perception of pain). Participants also rated overall pain and pain in specific body regions for each of the three trimesters. Estimations of fetal position before birth were given. Findingshigher pain ratings during the third trimester of pregnancy were associated with increased incidence of caesarean section, assisted delivery and a longer duration of labour. Specifically, lower back and pelvic pain were associated with an increase in complications, potentially due to occurrence of malpositioning of the fetus during pregnancy. Conclusionmothers who experience high levels of pain during pregnancy may be at increased risk of complications during labour. Explanations for this may be physiological, mechanical or psychological but greater awareness should be given to the potential impact of maternal pain ratings during pregnancy upon birth outcomes.