Labor Pain Perception: a Narrative Literature Review

Aim: Labor pain is one of the most intense and complex painful experiences, yet its perception varies widely among women. Traditional explanations based solely on nociceptive mechanisms are insufficient to account for these interindividual differences. Therefore, this review aims to summarize current evidence on the physiological, psychological, and genetic factors influencing labor pain perception, in order to better understand individual variability. Materials and Methods: A narrative review of the literature was conducted using recent peer-reviewed studies retrieved from PubMed, Scopus, and Web of Science. Articles exploring physiological mechanisms, psychological influences, and genetic polymorphisms associated with labor pain were included. Results: Labor pain arises from the interaction of nociceptive mechanisms, genetic variability (e.g., SERT, OPRM1, COMT polymorphisms), and psychological factors such as trait and state anxiety, fear of childbirth, coping strategies, and expectations. Social determinants, including prenatal education, partner and healthcare support, and cultural context, further modulate pain perception. Evidence supports significant gene–environment interactions, where genetic predispositions are amplified or buffered by psychological states and environmental influences. Conclusion: Labor pain is best understood within a bio-psychosocial framework that integrates biological vulnerability, emotional regulation, and contextual factors. Identifying women at increased risk for heightened pain perception may facilitate personalized obstetric care, combining targeted psychological interventions, structured prenatal education, and, in the future, genetically informed pain management strategies.