Which factors before and during pregnancy can predict the severity of labourpain? A observational prospective cohort study in women and their partners to the pain threshold before and during pregnancy, constitution, inflammatory status and the relationship with and the character of the partner.

Pain experienced by women during childbirth is the most intense acute pain.
During labour 60 - 80% of the women experiences severe to unbearable pain. Some
factors have their positive (self-efficacy, pregnancy course) or negative
influence (anxiety, stress and low back pain during menstruation) to the pain
intensity. Knowledge about other factors before or during pregnancy that can
predict the severity of labour pain are hardly available due to the high global
use (> 60%) of epidural analgesia during labour. In the Netherlands, the use of
epidural analgesia is relatively low (± 10%). This study can obtained insights
about the pain threshold, pro inflammatory status, constitution of the woman,
her relationship and the character of her partner and their impact on the
intensity of pain during labour.

The primary objective is to examine whether the pain threshold during pregnancy
is associated with the intensity of the pain and whether there is difference
between before and during pregnancy. In addition, we examine associations
between (pro) inflammatory status, the constitution of the woman, the
relationship with her partner and the character of her partner.

The proposed study is an observational prospective cohort study.

The burden of the participants consists of measuring the pain threshold (2 x
half hours) or the venapuntion (2 x 5 min, 30 ml total) during a home visit and
filling out the questionnaires (total 2 hours). Also there is a burden to
obtain the VAS during labour.
The risk with participation of the study is small and is related to algometry
(haematoma or pain on the pressure point), the venapunction (risk of fainting
or haematoma) or filling out the questionnaires (stress) during a home visit.