Table 1 Description of included studies

Higher maternal satisfaction with pharmacological pain relief

Orange [56]

2012

Brazil

70

Randomized controlled study

P*and NP**

Term pregnancies

100% vaginal births.

Mean age 22 years.

Combined spinal epidural analgesia (CSE) (50%) compared to non-pharmacological pain relief

Higher maternal satisfaction among women receiving combined spinal epidural analgesia (CSE)

1–5 Likert scale / immediately

No statistically significant difference between groups in rate of CS^##, instrumental birth, oxytocin induction, duration of expulsion phase or neonatal outcomes

Liu [70]

2021

China

4192

Cross sectional study

P* and NP** Gestational age > 32 weeks.

100% vaginal births

Mean age 29,8 years

Epidural analgesia (EDA^§) (75,6%) compared to no EDA^§

Higher maternal satisfaction among women receiving epidural analgesia (EDA^§)

1–10 Likert scale

/2–3 h

Duola or family member present, use of breathing technique and warm perineal compress were other factors associated with higher maternal satisfaction

Lower maternal satisfaction with pharmacological pain relief

Börjesson [66]

2007

Sweden

518

Prospective co-hort study

NP**

89% Vaginal births.

Mean age 27,2 years

EDA^§ (65%) compared to no EDA^§

Higher odds for a negative birth experience among women receiving EDA^§

VAS 1–100 mm

/within 3 months

Elective CS^## were excluded.

Other modes of delivery than unassisted vaginal birth were associated with a higher risk of a negative birth experience

Fenaroli [65]

2019

Italy

111

Prospective longitudinal study

NP**

Term pregnancies.

80.6% vaginal births.

Mean age 32 years

EDA^§ (45,4%) compared to no EDA^§

Less positive birth experience among women receiving EDA^§

W-DEQ (B) ^#

/ 1–5 days

Elective CS^## were excluded

No significant association between birth experience and mode of delivery or induction of labor

Fernández-Arranz [64]

2019

Spain

89

Randomized controlled study

P* and NP**

100% Vaginal births.

Mean age 32,9 years

Haloperidol and Pethidine (49%) compared to use of birthing ball

Lower maternal satisfaction among women who received Haloperidol and Pethidine

Mackey Satisfaction Childbirth Rating Scale ^#

/before discharge

No blinding of participants or investigators

Fumagalli [71]

2021

Italy

277

Cross sectional study

P* and NP**.

Term pregnancies.

94,4% vaginal births.

Mean age 33 years

EDA^§ (32%) compared to no EDA^§

Lower maternal satisfaction among women who received EDA^§

BSS-R ^#

/before discharge

Active phase of labor > 12 h and vacuum assisted birth was associated with a lower birth satisfaction

Johansson [68]

2019

Sweden

584

Cross sectional study

NP**

86.5% vaginal births.

Mean age 29 years

EDA^§ (35%) compared to no EDA^§

Higher odds for a negative birth experience among women receiving EDA^§

1–10 Likert scale

/ immediately

Oxytocin induction significantly associated with use of EDA^§

Mixed groups: Morphine, nitrous oxide and EDA^§ not separated

Lathrop [73]

2018

USA

122

Case control study

P* and NP**

Term pregnancies

100% vaginal births

Age > 18 years

EDA^§ (46%) compared to water birth

Less positive childbirth experience among women receiving EDA^§

CEQ ^#

/ 1–7 days

Primary aim of study was to explore benefits with water birth compared to conventional birth

Lindholm [61]

2015

Sweden

866

Prospective longitudinal study

P* and NP**

82% vaginal births.

Majority aged 25–35 years

EDA^§ (32%) compared to no EDA^§

Nitrous oxide (85%) compared to no nitrous oxide

Less positive birth experience among women receiving EDA^§

No association found between nitrous oxide and birth experience

1–5 Likert scale

/ 2 months

Elective CS^## were excluded.

Primary aim of study was to identify factors associated with preferred pain relief methods

Lyngbye [62]

2022

Denmark

201

Prospective cohort-study

P* and NP**

Term pregnancies

92% vaginal births

Mean age 29,2 years

EDA^§ (26,7%) compared to no EDA^§

Nitrous oxide (47%) compared to no nitrous oxide

Use of EDA^§ was associated with a led positive childbirth experience

Use of nitrous oxide was associated with a less positive childbirth experience

CEQ ^#

/6 weeks

52% of the women reported a lower satisfaction score after 6 weeks compared to after 1 week

Nystedt [74]

2018

Sweden

928

Cross sectional study

P* and NP** Uncomplicated pregnancies

82% vaginal deliveries

Majority aged 25–35 years

Obstetric analgesia (31%) compared to no obstetric analgesia

Higher odds for a negative birth experience among women receiving obstetric analgesia

Likert scale 1–5

/2 months

No definition of the term “obstetric analgesia”

Other modes of delivery than unassisted vaginal birth, were associated with a higher risk of a negative birth experience

Waldenström [57]

1999

Sweden

1111

Prospective longitudinal study

P* and NP**

84.3% vaginal deliveries.

Mean age 30 years

Nitrous oxide (33%) compared to no nitrous oxide

Use of nitrous oxide was associated with a a negative birth

Likert scale 1–7

/ 2 months

No association found for EDA^§ or Pethidine

Mixed groups: EDA^§, Pethidine and Nitrous oxide not separated

Waldenström [13] 2004

Sweden

2541

Prospective longitudinal study

P* and NP**

92% vaginal births. Mean age 29.5 years

EDA^§ (30%) compared to no EDA^§

Higher risk for a negative birth experience among women receiving EDA^§.

Likert scale 1–7^#

/ 2 months

Emergency CS^##, instrumental birth, induction, strong pain, not part of decision-making and child to neonatal unit were correlated to a risk of a negative birth experience

Weeks [69]

2017

Chile

1534

Cross sectional study

P* and NP**.

80% vaginal births Age 18–32 years

Pharmacological pain management (74%, nitrous oxide or EDA^§) compared to no pharmacological pain management

Lower maternal satisfaction among women receiving pharmacological pain management

Maternal well-being scale, by Uribe et al. 42-questions ^#

/ 1–2 days

CS^##, continuous monitoring of fetal heartbeat and episiotomy were associated with a lower maternal satisfaction

No association found between maternal satisfaction and pharmacological pain relief

Larsson [37]

2011

Sweden

280

Prospective longitudinal study

NP** at term.

56% vaginal births

Age not supplied

EDA^§ (26,3%) compared to no EDA^§

No association found between EDA^§ and birth experience

W-DEQ (B)^#

/ 9 months

Secondary aim of study was to compare the assessment tools W-DEQ (B) and VAS

Mixed population, evaluating both vaginal births and caesarean section

Rijnders [67]

2008

Netherlands

1293

Retrospective cohort study

P* and NP**

86.9% vaginal births

Mean age 31 years

Pain relief (14%) compared to no pain relief

No association found between pain relief and recall of birth experience

One question from “Greater Expectations” ^#

/ 3 years

Assisted vaginal, non-elective CS^##, referral during birth, no choice of pain relief and dissatisfaction with coping with pain were associated with a negative recall of child-birth

No information supplied regarding type of pain relief

Spaich [44]

2013

Germany

335

Prospective longitudinal study

P* and NP**. At term pregnancies.

65% vaginal birth. Median age 31 years

Intravenous pain medication and EDA^§ compared to no pain relief

No association found between pharmacological pain relief and birth experience

Salmon Item List^#

/Before discharge from hospital

High level of pain perception was associated with risk for a negative experience

No significant association found between mode of delivery and birth experience

Such [63]

2021

USA

84

Cross sectional study

P* and NP**. At term

Uncomplicated pregnancies.

100% vaginal births.

Age > 18 years.

EDA^§ (33%) compared to no epidural analgesia

Nitrous oxide (33%) compared to no nitrous oxide

No significant difference in satisfaction with birth experience between groups

No significant difference in satisfaction with birth experience between groups

BSS-R^#

/within 6 h

Income and education were independently associated with a higher birth satisfaction score