Severe Recalled Labor Pain and Elective Cesarean Section in a Subsequent Delivery: A Cohort Study of Norwegian Parous Women

( Acta Obstet Gynecol Scand . 2021;100:1678–1687) Although the pain experienced in labor is quickly forgotten by most women, some with negative childbirth experiences may recall intense labor pain years later. These women may experience postpartum anxiety which can have a negative impact on the women and their ability to tend to their newborns. This can also affect other childbearing decisions including increased spacing between pregnancies, a reduced number of children, and an increased request for elective cesarean delivery (CD) in subsequent pregnancies. The rate of CD in Norway has risen by 13.3% from 1972 despite the WHO CD recommendation of a 10% to 15% CD rate together with evidence that there is no reduction in maternal or child mortality if the CD rate is >10%. With patient-requested CD increasing, the authors from Norway investigated whether a patient’s recall of labor pain from a previous vaginal delivery (VD) influenced their preference for their future mode of delivery. In addition, potential confounders such as maternal demographic, somatic and mental health factors were also evaluated in case these may have influenced such an association.