***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby . However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care . This study elicits women ’s preferences for the most important elements of their childbirth experiences . Methods A mixed methods design was used . An initial qualitative phase ( reported previously ) was followed by a second quantitative one using a discrete choice experiment ( DCE ) , which is reported on here . Participants who had experienced labour , were over 18 and had a healthy baby were recruited from four r and omly selected and one pilot hospital in the Republic of Irel and . Data were collected by means of a DCE survey instrument . Questions were piloted , refined , and then arranged in eight pair-wise scenarios . Women identified their preferences by choosing one scenario over another . Nine hundred and five women were sent the DCE three months after childbirth , with a response rate of 59.3 % ( N = 531 ) . Results Women clearly identified priorities for their childbirth experiences as : the availability of pain relief , partnership with the midwife , and individualised care being the most important attributes . In the context of other choices , women rated decision-making , presence of a consultant , and interventions as less important elements . Comments from open questions provided context ual information about their choices . Conclusions Most women did not want to be typified as wanting the dichotomy of ‘ all natural ’ or ‘ all technology ’ births but wanted ‘ the best of both worlds ’ . The results suggest that availability of pain relief was the most important element of women ’s childbirth experiences , and superseded all other elements including partnership with the midwife which was the second most important attribute . The preferences identified might reflect the busy medicalised hospital environments , in which the vast majority of women had given birth , and may differ in setting s such as midwifery led care or home births OBJECTIVE to gain insight into the experiences of women , partners and midwives who participated in the Complementary Therapies for Labour and Birth Study , an evidence based complementary medicine ( CM ) antenatal education course . DESIGN qualitative in-depth interviews and a focus group as part of the Complementary Therapies for Labour and Birth Study . SETTING AND PARTICIPANTS thirteen low risk primiparous women and seven partners who had participated in the study group of a r and omised controlled trial of the complementary therapies for labour and birth study , and 12 midwives caring for these women . The trial was conducted at two public hospitals , and through the Western Sydney University in Sydney , Australia . INTERVENTIONS the Complementary Therapies for Labour and Birth ( CTLB ) protocol , based on the She Births ® course and the Acupressure for labour and birth protocol , incorporated six evidence -based complementary medicine ( CM ) techniques ; acupressure , relaxation , visualisation , breathing , massage , yoga techniques and incorporated facilitated partner support . R and omisation to the trial occurred at 24 - 36 weeks ' gestation , and participants attended a two-day antenatal education programme , plus st and ard care , or st and ard care alone . FINDINGS the overarching theme identified in the qualitative data was making sense of labour and birth . Women used information about normal birth physiology from the course to make sense of labour , and to utilise the CM techniques to support normal birth and reduce interventions in labour . Women 's , partners ' and midwives ' experience of the course and its use during birth gave rise to supporting themes such as : working for normal ; having a toolkit ; and finding what works . KEY CONCLUSIONS the Complementary Therapies for Labour and Birth Study provided women and their partners with knowledge to underst and the physiology of normal labour and birth and enabled them to use evidence -based CM tools to support birth and reduce interventions . IMPLICATION S FOR PRACTICE the Complementary Therapies for Labour and Birth Study introduces concepts of what constitutes normal birth and provides skills to support women , partners and midwives . It appears to be an effective form of antenatal education that supports normal birth , and maternity services need to consider how they can reform current antenatal education in line with this evidence We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting ( MBCP ) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy .  MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples .  MBCP is design ed to promote family health and well-being through the practice of mindfulness during pregnancy , childbirth , and early parenting . Quantitative results from the current study include statistically significant increases in mindfulness and positive affect , and decreases in pregnancy anxiety , depression , and negative affect from pre- to post-test ( p < .05 ) . Effect sizes for changes in key hypothesized intervention mediators were large ( d > .70 ) , suggesting that MBCP is achieving its intended effects on maternal well-being during pregnancy . Qualitative reports from participants exp and upon the quantitative findings , with the majority of participants reporting perceived benefits of using mindfulness practice s during the perinatal period and early parenting . Our future research will involve conducting a r and omized controlled trial of MBCP to test effects on psychophysiological stress mechanisms and to examine effects on birth outcomes , family relationship quality , and child development outcomes BACKGROUND Pain during childbirth is a well known cause of dissatisfaction amongst women in labor . The use of epidural analgesia in labor is becoming widespread due to its benefit in terms of pain relief . METHOD After approval of the local Ethics Committee on Research and obtaining informed written consent , 50 American Society of Anesthesiologists ( ASA ) class I-II consecutive multiparous women in labor requesting pain relief were enrolled in this prospect i ve study . After providing description of the two options of pain relief available to them , they were allocated into two groups according to their request-to receive either parenteral opioid/sedative or epidural labor analgesia . Both groups received analgesia of choice at 4-cm cervical os dilatation . The epidural group received 0.125 % plain bupivacaine , while the other group received pentazocine/promethazine intravenously . The time taken to locate the epidural space , catheter-related complications encountered and the amount of intravenous fluid used were documented . RESULT The two groups were comparable in terms of socio-demographic data . The mean duration of the first and second stages of labor , respectively , were significantly shorter in the epidural group when compared with those in the non-epidural group ( [ P < 0.01 ] and [ P < 0.02 ] ) . There was no difference in the rate of cesarean delivery between them - epidural analgesia ( 32 % [ 8/25 ] ) versus parenteral opioid/sedative ( 44 % [ 11/25 ] ) , ( OR , 0.60 ; 95 % CI , 0.19 - 1.90 ) . The maternal blood loss from delivery was minimal , with no statistical difference between the two groups ( P = 0.27 ) . The neonatal outcome was the same in both groups . Closed question naire showed that the overall experience of labor was much better ( it was also better than expected ) in the epidural group when compared with that in the non-epidural group ( 80 % versus 4 % ) . Eighteen ( 72 % ) women had inadequate pain relief in the non-epidural group as compared to 2 ( 8 % ) women in the epidural group . CONCLUSION The study shows that epidural labor analgesia is acceptable to women in our setting . More women in the epidural analgesia group were satisfied with the experience of labor than those who did not receive this form of analgesia than among those who received parenteral opioid/sedative Background . We investigated whether patient‐controlled epidural analgesia  in labor with bupivacaine and fentanyl provides more satisfaction to mothers than intermittent bolus epidural analgesia or patient‐controlled epidural analgesia with plain bupivacaine . Methods . Ninety mothers with term , uncomplicated pregnancies were r and omized to receive intermittent bolus epidural analgesia ( bupivacaine + fentanyl ) , patient‐controlled epidural analgesia ( bupivacaine + fentanyl ) , or patient‐controlled epidural analgesia ( bupivacaine ) .  Pain during labor was evaluated with a visual analog scale . Obstetric and neonatal outcomes were recorded . After delivery , the mothers were given a question naire covering the following themes : experience of labor pain , feeling of control , fears and expectations associated with pregnancy/with delivery/with becoming a mother , as well as pain , physical condition and emotions after delivery . To elaborate on these answers , 30 mothers were further r and omized to a semistructured interview , in which the same topics were discussed . The main outcome measure was maternal satisfaction . Results . The intermittent bolus epidural analgesia group felt they could influence labor most ( p=0.03 ) , and in the interview they expressed most satisfaction . In this group , the total drug utilization was smallest ( bupivacaine : p<0.0001 comparing all groups , fentanyl : p=0.03 comparing the two fentanyl‐receiving groups ) . No differences in pain occurred . Vomiting ( p=0.04 ) and pruritus ( p<0.0001 ) were more common or more severe in the groups receiving fentanyl . Conclusions . We found no advantages for patient‐controlled epidural analgesia over intermittent bolus epidural analgesia in terms of maternal satisfaction OBJECTIVE To compare women 's experience of receiving either  intranasal fentanyl , subcutaneous fentanyl or intramuscular pethidine  for labour analgesia . DESIGN A content analysis was undertaken as part of the third phase of a larger r and omised controlled trial , using the per- protocol data set to examine women 's experiences of treatment received . Healthy women birthing at term , who received intranasal fentanyl ( n=41 ) , subcutaneous fentanyl ( n=37 ) and /or intramuscular pethidine ( n=38 ) for labour analgesia  , were contacted at 6 weeks postpartum to complete a phone question naire . SETTING A tertiary and regional maternity unit in South Australia . FINDINGS Over 80 % of women who received intranasal or subcutaneous fentanyl reported that they would use the treatment again compared to 44.8 % of women who had received pethidine ( self-administered intranasal fentanyl provided more expressive responses emphasising the route provided a strong sense of control and enablement . KEY CONCLUSIONS Route of administration influenced the women 's experience , more women who self-administered intranasal fentanyl reported positive emotional responses , with women reporting increased autonomy and satisfaction . Whereas , women who relied on the midwife to administer subcutaneous fentanyl or intramuscular pethidine , were more often focused on the physical effect of the drug . Pethidine was the least preferred option due to adverse effects . IMPLICATION S FOR PRACTICE For women requesting parenteral analgesia , fentanyl administered by less invasive routes offers women additional options that may better meet their emotional , cognitive and physical needs than the current practice of administering intramuscular pethidine UNLABELLED Feasibility r and omised controlled trials of complementary medicine are important to evaluate acceptability and practicality . This study examined participants ' and health professionals ' perceptions of CAM  and participation in a feasibility RCT of  acupressure  for labour onset . METHODS A qualitative study incorporated within an RCT . Data were collected from postnatal women via question naires and health professionals via focus groups . RESULTS Four themes emerged from the women 's views : " Using CAM to start labour " , " Feeling empowered through action " , " Desiring r and omisation to acupressure group " , and " Welcoming the opportunity to assist in research " . Five themes emerged from the health professionals ' views : " Personal awareness and attitudes towards CAM " ; " Supporting and empowering women " ; " Complements the wellness model of pregnancy and childbirth " ; " Need for evidence d based practice " ; and " R and omisation ' doing it on the sly ' " . CONCLUSIONS Themes from the groups were similar . The study protocol will be refined with a placebo group to improve equipoise with a powered RCT planned 
    Output:
    
‘ Desires for pain relief ’ illuminates different reasons for using pharmacological or non-pharmacological pain relief  .
‘ Impact on pain ’ describes varying levels of effectiveness of the methods used . ‘
Influence and experience of support ’ highlights women ’s positive or negative experiences of support from professionals and /or birth companions . ‘
Influence on focus and capabilities ’ illustrates that all pain relief methods can facilitate maternal control , but some found non-pharmacological techniques less effective than anticipated , and others reported complications associated with medication use .
Finally , ‘ impact on wellbeing and health ’ reports that whilst some women were satisfied with their pain relief method , medication was associated with negative self-reprisals , whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes .
Conclusion Women report mixed experiences of different pain relief methods .
Pharmacological methods can reduce pain but have negative side-effects .
Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters .