Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA; Texas A&M Institute for Neuroscience, College Station, TX, 77843, USA.
Department of Sociology, Texas A&M University, 4351 TAMU, College Station, TX, 77843, USA.
Soc Sci Med. 2020 Sep;261:113240. doi: 10.1016/j.socscimed.2020.113240. Epub 2020 Jul 27.
We assess American cultural beliefs about labor pain and labor pain management, including stereotypical and disparate beliefs about labor pain of women from different racial groups.
Understanding cultural beliefs about labor pain is critical as these beliefs influence experience, interpretation, and treatment of labor pain.
We used an online survey with quantitative and qualitative questions about American labor pain beliefs. Participants were recruited and compensated using TurkPrime's Panels during the first week in August 2017 and the last week in May 2018. The completion rate was 76.86 percent (n = 214). After screening using quality control items, the final sample included 200 respondents.
Qualitative results indicate that 56.5 percent (n = 113) of respondents have an accurate understanding of nociceptive/sensory drivers of labor pain, and 55.8 percent (n = 63) of those respondents focused on the second stage of labor. However, only two respondents (1%) mentioned non-sensory (i.e., psychological) causes of labor pain - reflecting a lack of cultural knowledge of the biopsychosocial nature of pain. Categorical responses indicate almost all respondents (95%; n = 190) believe women have a right to labor pain relief, and the majority believe labor pain has value (68%; n = 136) and should be treated medically (87%; n = 174). Quantitative results document stereotypical beliefs that women of color experience less labor pain than white women. Belief that there is value in experiencing labor pain and that pain should not be treated medically were both associated with greater racial disparities in beliefs about labor pain severity. Beliefs were not related to respondent sociodemographic identity, suggesting they are American cultural constructs.
Future consideration of the influence of dominant American cultural beliefs about labor pain - including misunderstanding of the nature of labor pain and racial bias in expectations of labor pain - on individuals, norms, and structures is expected to improve quality of patient care.
我们评估了美国人对分娩疼痛和分娩疼痛管理的文化观念，包括对不同种族女性分娩疼痛的刻板和不同的观念。
了解分娩疼痛的文化观念至关重要，因为这些观念会影响对分娩疼痛的体验、解释和治疗。
我们使用了一项在线调查，其中包含关于美国分娩疼痛观念的定量和定性问题。参与者是在 2017 年 8 月的第一周和 2018 年 5 月的最后一周通过 TurkPrime 的 Panels 招募和付费的。完成率为 76.86%（n=214）。在使用质量控制项目进行筛选后，最终样本包括 200 名受访者。
定性结果表明，56.5%（n=113）的受访者对分娩疼痛的伤害性/感觉驱动因素有准确的理解，55.8%（n=63）的受访者关注第二产程。然而，只有两名受访者（1%）提到了分娩疼痛的非感觉（即心理）原因——这反映了人们对疼痛的生物心理社会性质缺乏文化知识。分类反应表明，几乎所有受访者（95%；n=190）都认为女性有权减轻分娩疼痛，大多数人认为分娩疼痛有价值（68%；n=136），应该进行医学治疗（87%；n=174）。定量结果记录了刻板的观念，即有色人种的女性经历的分娩疼痛比白人女性少。相信体验分娩疼痛有价值，以及不应该进行医学治疗，这两者都与对分娩疼痛严重程度的种族差异观念有关。信念与受访者的社会人口身份无关，这表明它们是美国文化的构建。
未来考虑主导的美国文化观念对分娩疼痛的影响——包括对分娩疼痛性质的误解和对分娩疼痛期望的种族偏见——可能会提高患者护理的质量。
