Antenatal classes are failing to prepare women for the painful reality of childbirth, a study claims today.
New mothers are often shocked at the "intensity" of the pain they experience in labour, researchers from Newcastle University found.
"Unrealistic" expectations also led many to believe that they wouldn't need pain relief during childbirth.
A review of 69 studies, published in BMC Medicine, sought to discover whether the reality of the delivery room experience met expectations. It found that most women, especially those who were pregnant for the first time, underestimated the pain involved in labour.
In only one study did women report that labour had been less painful than they were led to believe, though they said individual contractions had been more intense than expected.
Many expectant mothers also had "unrealistic" expectations about wanting a drug-free labour. In one study, more than half who felt they would not need pain relief changed their mind in the delivery room.
Too few antenatal classes used birth plans and other measures designed to help mothers make realistic choices about their delivery, researchers said.
"People involved in antenatal care should listen to women's hopes for labour whilst also preparing them for what might actually happen," said Joanne Lally, from Newcastle University.
"Plans for a labour free of pain relief need to be complemented by preparing women for the possibility that they might need pain relief. Education can help to fill the gap between expectation and experience and thus ensure women are realistically prepared."
Gillian Fletcher, a former president of the The National Childbirth Trust, one the major private providers of ante-natal classes in the UK, said: "The bottom line is that we encourage women to have confidence in themselves and their bodies, but that doesn't mean we don't talk about pain relief in our ante-natal sessions.
"We help women weigh up the pros and cons of every method."
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