What do midwives need to know about approaches of women towards labour pain management? A qualitative interview study into expectations of management of labour pain for pregnant women receiving midwife-led care in the Netherlands.

Objective: to investigate factors important to women receiving midwife-led care with regard to their expectations for management of labour pain.

Design: semi-structured ante partum interviews and analyses using constant comparison method.

Participants: fifteen pregnant women between 36 and 40 weeks gestation receiving midwife-led care.

Setting: five midwifery practices across the Netherlands between June 2009 and July 2010.

Main Outcome: women's expectations regarding management of labour pain.

Results: we found three major themes to be important in women's expectations for management of labour pain: preparation, support and control and decision-making. In regards to all these themes, three distinct approaches towards women's planning for pain management in labour were identified: the 'pragmatic natural', the 'deliberately uninformed' and the 'planned pain relief' approach.

Conclusion: midwives need to recognise that women take different approaches to pain management in labour in order to adapt care to the individual woman.