141st APHA Annual Meeting

In This section

277798
Use of non-medical methods of labor induction and pain management among u.s. women

Monday, November 4, 2013 : 8:30 AM - 8:50 AM

Katy Kozhimannil, Ph.D., M.P.A. , Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN
Pamela Jo Johnson, MPH, PhD , Medica Research Institute, Minnetonka, MN
Laura Attanasio, BA , Division of Health Policy and Management, School of Public Health, Univeristy of Minnesota, Minneapolis, MN
Dwenda Gjerdingen, M.D., M.S. , Department of Family Medicine and Community Health, University of Minnesota Medical School, St. Paul, MN
Patricia M. McGovern, PhD, MPH , School of Public Health, University of Minnesota, Minneapolis, MN
Background Little is known about women's use of non-medical interventions to induce labor and manage pain during childbirth. We examined the prevalence of non-medical interventions for labor induction and managing labor pain and quantify the relationship between medical and non-medical care during labor.

Methods We used data from the Listening to Mothers II survey (N=1,382) to calculate the prevalence of specific non-medical methods of labor induction and pain management in labor and multivariate logistic regression to calculate the odds of non-medical and medical interventions to induce labor or mitigate labor pain.

Results More than 1/4 of pregnant women attempted to induce labor by non-medical means, most frequently via walk/exercise/movement (23.4%) or sexual intercourse (20.3%). The odds of medical labor induction more than doubled among women who used non-medical means of induction (AOR=2.44, p<0.01). Seventy percent of women used non-medical means of managing pain during labor, most commonly breathing techniques (51.0%), position changes (42.9%), and mental strategies (25.4%). Odds of medical pain management were 31% lower among women who used non-medical methods of labor pain management (AOR=0.69, p=0.061).

Conclusions Non-medical methods of labor induction and labor pain management are prevalent. Women who attempt to self-induce labor have higher odds of medical intervention to induce labor. Conversely, women who use non-medical methods of labor pain management are less likely to use medical means of pain management during labor. The interaction between alternative health strategies and medical services during childbirth to identify policies to improve the quality of maternity care should be explored.

Learning Areas:
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health administration or related administration

Learning Objectives:
Describe the prevalence and types of non-medical approaches to labor induction reported by pregnant women in the U.S. Describe the prevalence and types of non-medical approaches to labor pain management used by U.S. women during childbirth. Discuss the relationship between non-medical methods of labor induction and labor pain management and the use of medical services during labor and delivery.

Keywords: Alternative Medicine/Therapies, Maternal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctorally-trained health policy analyst and health services researcher with expertise in maternal health services and the perinatal period. I am the principal investigator of an NICHD-funded grant on health services use during childbirth and have published my research in peer-reviewed clinical and policy journals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.