Cultural conceptions of Women's labor pain and labor pain management: A mixed-method analysis

• Published in: Social science & medicine (1982) Vol. 261; pp. 113240 - 10
• Main Authors: Mathur, Vani A., Morris, Theresa, McNamara, Kelly
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2020; Pergamon Press Inc
• Subjects: Beliefs; Bias; Biopsychosocial aspects; Childbirth; Childbirth & labor; Cultural groups; Cultural values; Culture; European Continental Ancestry Group; Female; Gender stereotypes; Health disparities; Health equity; Humans; Labor; Labor pain; Labor Pain - therapy; Labor, Obstetric; Medical screening; Mixed methods research; Pain; Pain Management; Patients; Pregnancy; Quality control; Racial bias; Racial groups; Racial inequality; Racial stereotypes; Racism; Respondents; Sociodemographics; Surveys and Questionnaires; Tests; United States; Women; Labor pain; United States; Racial stereotypes; Health equity; Racial bias; Culture; Childbirth; Health disparities
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2020.113240

We assess American cultural beliefs about labor pain and labor pain management, including stereotypical and disparate beliefs about labor pain of women from different racial groups. Understanding cultural beliefs about labor pain is critical as these beliefs influence experience, interpretation, and treatment of labor pain. We used an online survey with quantitative and qualitative questions about American labor pain beliefs. Participants were recruited and compensated using TurkPrime's Panels during the first week in August 2017 and the last week in May 2018. The completion rate was 76.86 percent (n = 214). After screening using quality control items, the final sample included 200 respondents. Qualitative results indicate that 56.5 percent (n = 113) of respondents have an accurate understanding of nociceptive/sensory drivers of labor pain, and 55.8 percent (n = 63) of those respondents focused on the second stage of labor. However, only two respondents (1%) mentioned non-sensory (i.e., psychological) causes of labor pain - reflecting a lack of cultural knowledge of the biopsychosocial nature of pain. Categorical responses indicate almost all respondents (95%; n = 190) believe women have a right to labor pain relief, and the majority believe labor pain has value (68%; n = 136) and should be treated medically (87%; n = 174). Quantitative results document stereotypical beliefs that women of color experience less labor pain than white women. Belief that there is value in experiencing labor pain and that pain should not be treated medically were both associated with greater racial disparities in beliefs about labor pain severity. Beliefs were not related to respondent sociodemographic identity, suggesting they are American cultural constructs. Future consideration of the influence of dominant American cultural beliefs about labor pain – including misunderstanding of the nature of labor pain and racial bias in expectations of labor pain – on individuals, norms, and structures is expected to improve quality of patient care. •American beliefs about causes of labor pain are often inaccurate.•Beliefs focus on sensory/physical sources and ignore social/psychological factors.•Explicit belief that women of color experience less labor pain than white women.•General cultural beliefs about labor pain are associated with racial biases.