Evolution of women satisfaction with labor pain management: a real-time study across nine maternity units

Abstract Background A lack of consideration of labor pain by caregivers was a factor in women' dissatisfaction with their childbirth experience. The aim of this study was to measure changes in women' satisfaction with caregivers' consideration of their pain, to identify the environmental factors modifying the perception of pain and to measure their satisfaction about the moment of relief pain and the information received about pain support and management. Methods A multicentre prospective cohort study was conducted in nine French maternity units. Women admitted for vaginal birth of a singleton fetus at ≥ 37 weeks of gestation were included. Data were collected every two hours throughout labor using self-reported questionnaires assessing pain management satisfaction, environmental factors, and received information. Cervical dilatation and analgesia use were recorded. Satisfaction scores were analysed according to cervical dilatation and epidural analgesia status. Factors influencing pain perception were identified based on reported occurrences. Results Of the 225 women who agreed to participate, 215 received epidural analgesia. Their satisfaction scores remained consistently high throughout labor, averaging around 9.5/10. In women without epidural analgesia (n = 10), satisfaction declined after 6–7 cm of dilatation. On admission, 37.3% of all women reported pain-intensifying factors, mainly physical discomfort, sound and lighting, and staff unavailability. Two hours post-delivery, pain-intensifying factors were delayed pain relief, disturbing sound environment, and insufficient information on mobility and the possibility of drinking during labor. Conclusion Women satisfaction were high, especially after epidural analgesia. Modifiable factors such as timeliness of relief, environmental conditions, and autonomy warrant targeted interventions.