There exists limited documentation of nonmedical methods of
labor induction and pain management during childbirth in the United States. We estimated
the prevalence of nonmedical interventions for induction and pain management and
examined the association between medical and nonmedical care during labor. Methods: We
used a nationally representative survey of U.S. women who gave birth in 2005 (N = 1,382)
to examine use of nonmedical methods of labor induction and pain management. Using
logistic regression, we calculated odds of nonmedical and medical interventions to induce
labor or mitigate pain, and the odds of medical induction and obstetric analgesia by whether
nonmedical methods were reported. Results: Nearly 30 percent of women used nonmedical
methods to start labor, and over 70 percent of women used nonmedical pain management.
Doula support was the strongest predictor of nonmedical methods of labor induction
(Adjusted Odds Ratio [AOR] = 3.0) and labor pain management (AOR = 5.7). Use of
nonmedical pain management was significantly associated with decreased odds of medical
pain management (OR = 0.65); this relationship was attenuated with covariate adjustment.
Conclusions: Nonmedical methods to induce labor and manage pain during childbirth are
commonly used by U.S. women. Future research should examine effectiveness of these
strategies and their influence on medical services use. (BIRTH 40:4 December 2013)