To summarize what is known about satisfaction with childbirth, with particular attention
to the roles of pain and pain relief.
A systematic review of 137 reports of factors influencing women's evaluations of their
childbirth experiences. The reports included descriptive studies, randomized controlled
trials, and systematic reviews of intrapartum interventions. Results were summarized
qualitatively.
Four factors-personal expectations, the amount of support from caregivers, the quality
of the caregiver-patient relationship, and involvement in decision making-appear to
be so important that they override the influences of age, socioeconomic status, ethnicity,
childbirth preparation, the physical birth environment, pain, immobility, medical
interventions, and continuity of care, when women evaluate their childbirth experiences.
The influences of pain, pain relief, and intrapartum medical interventions on subsequent
satisfaction are neither as obvious, as direct, nor as powerful as the influences
of the attitudes and behaviors of the caregivers.