• José Manuel Costa-Martins, Marco Pereira, Henriqueta Martins, Mariana Moura-Ramos, Rui Coelho, and Jorge Tavares.
• From the Department of Anaesthesiology (J.M.C.-M.), Maternity Hospital Alfredo da Costa, Lisbon, Portugal; Faculty of Medicine (J.M.C.-M.), University of Porto, Porto, Portugal; Faculty of Psychology and Educational Sciences (M.P., M.M.-R.), University of Coimbra, Coimbra, Portugal; ISPA (H.M.), University Institute, Lisbon, Portugal; and Departments of Clinical Neurosciences and Mental Health (R.C.) and Anaesthesiology (J.T.), Hospital de São João, Faculty of Medicine, University of Porto, Porto, Portugal.
• Psychosom Med. 2014 Apr 1; 76 (3): 221-8.

ObjectiveTo examine the influence of attachment dimensions and sociodemographic and physical predictors in the experience of labor pain.MethodsEighty-one pregnant women were assessed during their third trimester of pregnancy and during labor. The perceived intensity of pain in the early stages of labor (3 cm of cervical dilatation) and before the administration of patient-controlled epidural analgesia was measured using a visual analog scale. Pain was also assessed indirectly based on anesthetic doses. Attachment was assessed using the Adult Attachment Scale-Revised.ResultsAttachment anxiety and avoidance were positively and significantly correlated with labor pain and anesthetic consumption. In the multivariate models, attachment anxiety was a significant predictor of higher pain at 3 cm of cervical dilatation (β = 0.36, p = .042) and before the administration of patient-controlled epidural analgesia (β = 0.51, p = .002). Older age (β = 0.31, p = .005), a shorter duration of labor (β= -0.41, p = .001), and attachment avoidance (β = 0.41, p = .004) were significant predictors of higher anesthetic use.ConclusionsThe study findings suggest that perceived labor pain and anesthetic use are strongly associated with attachment, rather than demographic and physical factors. These data support the importance of understanding the experience of labor pain within an attachment theoretical framework.

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