Title:
Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery.

Abstract:
Certain behaviors can be adopted by women to cope with labor pain according to their individual characteristics, which are currently called behavioral indicators during labor pain, and include facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory system functioning during delivery. Moreover, severity of pain and duration of labor can vary due to several factors including individual characteristics.
The purpose of the present study was to determine the relationship between behavioral indicators during labor pain, severity of pain, and delivery duration.
In this cross-sectional study, 120 low risk pregnant women who referred to Omolbanin (AS) Hospital in the city of Mashhad (Iran) for delivery in 2014, were selected via convenience sampling method, which was then followed by completion of demographic information forms. From cervical dilatation of 3-5 centimeters until delivery, the Labor Pain Coping Behavior Observation Form (comprised of 6 sub-groups of facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory function and severity and duration of pain) was completed during uterine contractions and every half an hour. Using the Inventory of Labor Information; vital signs, frequency of contractions, and duration of the first and second stages of labor were measured. Furthermore, the content validity of the questionnaire was determined and its reliability was confirmed by Cronbach's alpha method. Then, the data were analyzed using the SPSS version 16, through Pearson Product-Moment Correlation and Spearman's Rank-Order Correlation, Kruskal-Wallis test, and ANOVA.
According to the results, 16.2% of the individuals had undesirable behavioral indicators during labor pain, 50% of them were endowed with acceptable behaviors, and 33.8% of these women had desirable behaviors. The findings also revealed that the duration of the active phase of the first stage of labor (p<0.001 and r=-0.453), the duration of the second stage of labor (p<0.012 and r=-0.146), and the severity of pain (p<0.001 and r=-0.450) were significantly and inversely correlated with behavioral indicators during labor pain; i.e. an increase in the mean score of behavioral indicators during labor pain could lead to a decline in the duration of stages of labor and severity of pain.
It was concluded that behaviors demonstrated by women in labor had effects on their pains in the course of delivery, and there was also a relationship between the duration of stages of labor and its severity of pain. Therefore, it was recommended to turn attention to behaviors by women in labor in order to achieve a desirable clinical management.