Background: Pregnant women have preferences about how they intend to manage labour pain. Unmet intentions can result in negative emotions and/or birth experiences.

Objective: To examine the antenatal level of intention for intrapartum pain relief and the factors that might predict this intention.

Design: A cross-sectional online survey-based study.

Setting And Participants: 414 healthy pregnant women in the Netherlands, predominantly receiving antenatal care from the community-based midwife who were recruited via maternity healthcare professionals and social media platforms.

Methods: The attitude towards intrapartum pain relief was measured with the Labour Pain Relief Attitude Questionnaire for pregnant women. Personality traits with the HEXACO-60 questionnaire, general psychological health with the Mental Health Inventory-5 and labour and birth anxiety with the Tilburg Pregnancy Distress Scale. Multiple linear regression was performed with the intention for pain relief as the dependant variable.

Results: The obstetrician as birth companion (<.001), the perception that because of the impact of pregnancy on the woman's body, using pain relief during labour is self-evident (<.001), feeling convinced that pain relief contributes to self-confidence during labour (=.023), and fear of the forthcoming birth (=.003) predicted women were more likely to use pain relief. The midwife as birth companion (=.047) and considering the partner in requesting pain relief (=.045) predicted women were less likely to use pain relief.

Conclusion: Understanding the reasons predicting women's intention of pain management during labour, provides insight in low-risk women's supportive needs prior to labour and are worth paying attention to during the antenatal period.