Recently, several authors have questioned the reliability and validity of relying on retrospective assessment of labor pain. Many studies designed to determine the relationships between psychosocial and demographic factors and pain intensity during labor have relied on such measurements. The purpose of this prospective study was to determine if primiparas and multiparas can accurately remember the pain of labor. Fifty primiparas and 88 multiparas participated in the study. Prospective assessment of in-labor pain was performed using a Visual Analogue Scale (VAS) in 3 phases of labor. Retrospective assessment of labor pain was performed 2 days post partum using the VAS. Results showed that there were significant differences between the amount of actual pain reported and the amount of pain and discomfort remembered by both primiparas and multiparas. The mean rating for remembered discomfort was higher than for remembered pain. The subjects tended to deflate the intensity of their labor pain. The results suggest that previous studies that have relied on retrospective assessments of labor pain may be invalid.

Background: Individualbased measures for comorbidity are of increasing importance for planning and funding health care services. No measurement for individualbased healthcare costs exist in Sweden. The aim of this study was to validate the Johns Hopkins ACG Case-Mix System's predictive value of polypharmacy (regular use of 4 or more prescription medicines) used as a proxy for health care costs in an elderly population and to study if the prediction could be improved by adding variables from a population based study i.e. level of education, functional status indicators and health perception.

Expectations of labor and childbirth can affect the degree of in-labor pain or discomfort experienced by the mother. By ascertaining whether expectations of labor experience are realistic or not, women can be prepared during the antenatal period to cope better with labor pain. The purposes of this prospective study were to 1) determine if pregnant women had realistic expectations of the labor experience, 2) determine if women who expected to have more pain during labor actually experienced more pain, than those not expecting to experience so much pain, and 3) determine if attending midwives assessed in-labor pain as intense as the mothers did. Fifty primiparas, 88 multiparas, and 12 full-time employed midwives participated in the study. The Visual Analogue Scale (VAS) was used to rate the expected and actual in-labor experience. A 3-point rating scale was used by the midwives to rate in-labor pain. Neither primiparas nor multiparas were found to have realistic expectations of the labor experience. Mothers experienced more pain and discomfort than expected, and the multiparas anticipated their need for medication to be greater than what was actually needed. The mothers reported that they felt less lonely and received more support from personnel during labor than they had expected. Multiparas who expected to experience more pain reported more pain than those expecting to experience less pain in stages I and III of labor. There was no significant correlation between midwives' and mothers' rating of the intensity of in-labor pain during stage III of labor.

The purpose of this prospective study was to determine (a) if background factors, emotional feelings, and mothers' expectations influence pain intensity during labor, and (b) if primiparas differ from multiparas in regard to these factors. A convenience sample of 50 healthy primiparas and 88 healthy multiparas, ranging in age from 17-41 years, was used. Demographic data were collected at 33 weeks gestation, and pain intensity was measured during three different phases of labor using a Visual Analogue Scale and the Pain-o-meter, a new pain assessment tool. The following factors correlated with more emotional feelings towards pregnancy and higher intensity of in-labor pain: (a) parity, (b) younger age, (c) less education, (d) more menstrual problems, (e) history of abortion, (f) unstable emotional feelings, (g) unrealistic expectations of pain and discomfort, (h) more pain relieving drugs during labor and delivery, and (i) a mate with negative or indifferent feelings toward the pregnancy.