title: The intensity of labor pain in grand multiparas.
abstract: BACKGROUND
  The purpose of the current study was to investigate differences in pain experiences and requirements for pain control in parturients 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 therefore been assumed to be minimal in this group.
  
  
  METHODS
  The pain experience 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 assessed on a pain intensity scale (0-10) according to the progress of cervical dilatation at the first and second stage of labor.
  
  
  RESULTS
  During the latent phase of cervical dilatation (0-3 cm) grand multiparas had a median pain score of 3 compared to 4 in II-V paras and 6 in primiparas (p<0.001). At the end of the first stage and during the second stage the intensity of pain in grand multiparas was significantly higher 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 9-10) 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, including grand multiparas, suffered from intense pain during labor. After delivery, a significant number of grand multiparas felt that they had received insufficient pain relief.
authors.affiliation: Department of Anaesthesiology, Oulu University Hospitial, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Ranta
authors.forename: P
authors.initials: P
authors.lastname: Jouppila
authors.forename: R
authors.initials: R
authors.lastname: Jouppila
mesh_terms: D016362:Analgesia, Obstetrical / Q000379:methods*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000209:etiology / Q000503:physiopathology*; D010298:Parity; D017699:Pelvic Pain / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies