It is also noted that the relatively small sample size does not allow us to generalize upon the findings reported here and further studies in this area are recommended It would be also be to monitor pain relief over a longer period and the impact of this intervention in reducing and maintaining pain reduction during labor, the actual childbirth and possible effect on the neonate by recording Apgar status. Finally, it would be interesting to undertake comparative cultural studies in the management and effectiveness of these pain relief measures during labor and childbirth.