Use of Nonmedical Methods of Labor Induction and Pain Management Among U.S. Women

Authors

  • Katy B Kozhimannil PhD, MPA,

    Assistant Professor, Corresponding author
    1. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
    • Address correspondence to Katy Backes Kozhimannil, Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, USA.

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  • Pamela J Johnson MPH, PhD,

    Research Investigator, Adjunct Assistant Professor
    1. Medica Research Institute, Minnetonk, MN, USA
    2. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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  • Laura B Attanasio BA,

    Doctoral Student
    1. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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  • Dwenda K Gjerdingen MD, MS,

    Professor
    1. Department of Family Medicine and Community Health, University of Minnesota Medical School and University of Minnesota Physicians, Minneapolis, MN, USA
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  • Patricia M McGovern PhD, MPH

    Professor
    1. Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
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  • This research was supported by a grant from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD; grant number R03HD070868) and the Building Interdisciplinary Research Careers in Women's Health Grant (grant number K12HD055887) from NICHD, the Office of Research on Women's Health, and the National Institute on Aging, at the National Institutes of Health, administered by the University of Minnesota Deborah E. Powell Center for Women's Health.

Abstract

Background

There exists limited documentation of nonmedical methods of labor induction and pain management during childbirth in the United States. We estimated the prevalence of nonmedical interventions for induction and pain management and examined the association between medical and nonmedical care during labor.

Methods

We used a nationally representative survey of U.S. women who gave birth in 2005 (N = 1,382) to examine use of nonmedical methods of labor induction and pain management. Using logistic regression, we calculated odds of nonmedical and medical interventions to induce labor or mitigate pain, and the odds of medical induction and obstetric analgesia by whether nonmedical methods were reported.

Results

Nearly 30 percent of women used nonmedical methods to start labor, and over 70 percent of women used nonmedical pain management. Doula support was the strongest predictor of nonmedical methods of labor induction (Adjusted Odds Ratio [AOR] = 3.0) and labor pain management (AOR = 5.7). Use of nonmedical pain management was significantly associated with decreased odds of medical pain management (OR = 0.65); this relationship was attenuated with covariate adjustment.

Conclusions

Nonmedical methods to induce labor and manage pain during childbirth are commonly used by U.S. women. Future research should examine effectiveness of these strategies and their influence on medical services use.

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