Women’s Attachment as a Predictor of Pain During Labour and Post-Delivery: a Prospective Observational Study

José Manuel Costa Martins, Carlos Fernandes da Silva, Marco Pereira, Henriqueta Martins, Célia Oliveira, Alexandra Puga, Rui Coelho, Jorge Tavares


Introduction: Labour is considered to be one of the most painful and significant experiences in a woman’s life. The aim of this study was to examine whether women’s attachment style is a predictor of the pain experienced throughout labour and post-delivery.
Material and Methods: Thirty-two pregnant women were assessed during the third trimester of pregnancy and during labour. Adult attachment was assessed with the Adult Attachment Scale – Revised. The perceived intensity of labour pain was measured using a visual analogue scale for pain in the early stage of labour, throughout labour and post-delivery.
Results: Women with an insecure attachment style reported more pain at 3 cm of cervical dilatation (p < 0.05), before the administration of analgesia (p < 0.01) and post-delivery (p < 0.05) than those securely attached. In multivariate models, attachment style was a significant predictor of labour pain at 3 cm of cervical dilatation and before the first administration of analgesia but not of the perceived pain post-delivery.
Discussion: These findings confirm that labour pain is influenced by relevant psychological factors and suggest that a woman’s attachment style may be a risk factor for greater pain during labour.
Conclusion: Future studies in the context of obstetric pain may consider the attachment style as an indicator of individual differences in the pain response during labour. This may have important implications in anaesthesiology and to promote a relevant shift in institutional practices and therapeutic procedures.
Keywords: Labor Pain; Labor, Obstetric; Maternal-Fetal Relations; Object Attachment.

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