Joint data collection by nine nurse-midwifery practices in the United States permitted a description of pain management practices with intrapartum patients. Observational data are reported for healthy gravidas at term (N = 4,171). A wide variety of techniques for pain management, including both pharmacologic and nonpharmacologic methods, were used. High prevalence modalities were paced breathing (used by 55.2% of this clinical sample), activity and position change (42.4%), narcotics (30.0%), and epidurals (18.7%). Paced breathing plus narcotics was the most common combination. Variations are reported for subgroups of women according to age, parity, race/ethnicity, education, insurance, marital status, activity in labor, and type of delivery. The only methods associated with a lowered rate of spontaneous delivery were epidurals and intrathecal narcotics.