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It haunts expectant mothers as the excitement of becoming pregnant gives way to the reality of giving birth... how will they cope with labour?But what's better? A longer labour with relatively less pain - or a shorter labour with excruciating pain?
When pregnant women were questioned, the majority opted for the longer, more drawn out labour - preferring to take their time rather than endure terrible pain.
A questionnaire filled out by expectant mothers revealed the majority would prefer a longer labour with less pain rather than a short-sharp burst of excruciating pain
Lead author of the study, Dr Brendan Carvalho from the Stanford University School of Medicine in California, said: 'Interestingly, intensity is the driver.'
Using an epidural 'may prolong labour but reduces pain intensity, and it seems that could be preferable to most', he said.
The women taking part in the study were given a seven-item questionnaire as they arrived at hospital to have labour induced but before painful contractions began.
The women took the survey a second time within 24 hours of giving birth.
The survey pitted hypothetical pain level, on a scale of zero to 10, against hours of labour.
A sample question asked: 'Would you rather have pain intensity at two out of 10 for nine hours or six out of 10 for three hours?'
Researchers said an epidural can prolong labour but it reduces pain intensity
Both pre and post-labour, women taking part on average preferred less intense pain over a longer duration, according to the findings published in the British Journal of Anaesthesia.
Dr Ruth Landau, from the University of Washington Medical Center in Seattle, said the women were all due to be induced and as a result may have been expecting a longer labour in any case.
She said it would be interesting to see the results of the questionnaire given to women who are not induced, or who do not plan to have an epidural.
Dr Landau, who did not take part in the study, said it may reassure women who believe they want to have an epidural that they are making the right decision to have an early analgesic.
'Obviously if we could control pain and duration, dial them both up and down based on what women wanted, we would do that,' she said.
'But we don’t have a way to dial up or down duration of labour,' she told Reuters Health.
There is some evidence that an epidural may prolong labour, but it’s not unanimous, she said.
'What we can do and should do is better inform women that we know that most women prefer low intensity of pain, particularly first-time moms,' Dr Landau added.
Dr Carvalho said: 'Labor’s got a lot of factors to it, it’s difficult to capture in one score.'
'The one good thing that does happen in labor is we use patient controlled analgesia.
'Women control how much medication they get, which is better than getting prescribed a set dose from start to finish.
'More medication makes legs heavy, may make labor longer and will more likely involve forceps or vacuum (to help deliver the baby), and less medication means more intense pain and also the ability to be more active.
'Women would benefit from more conversation about this.'
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