This study investigates efficacy, safety and childbirth experience in women receiving pudendal block during the final stage of delivery. It is an observational study and half of included primarous women recieve a pudendal block.

Pudendal block is used when there is a need to alleviate pain in the final stage of labour:

• From fully dilated cervix to delivery of the child.
• Associated with pain as the foetus rotates and descends through the pelvis.
• End of second stage: the perineum dilates as the child is being born.

Pudendal block is provided by inserting a needle close to the pudendal nerve that runs through the pelvis and innervates the perineal area.Pudendal block is an old and relatively simple method, but not well studied. The main aim is to study pudendal nerve block as pain relief in final stage of labour for primiparous women delivering vaginally.

The investigators aim to investigate whether possible adverse effects may outweigh the positive analgesic effect in the final stage of labour, or the opposite. The ASL (Analgesia in the Second stage of Labour) study may fill knowledge gaps and add important knowledge regarding pain relief during the final stage of childbirth.

Inclusion Criteria:

• Norwegian-speaking/reading
• Primiparity
• Single pregnancy
• Vaginal birth
• Cephalic presentation
• ≥37+0
• Age ≥18 years

Exclusion Criteria:

• Transferre from midwifery-led birth unit
• Allergy to local anaesthesia
• Not valid data on pudendal block

The participants is selected from 2 delivery units at Oslo Univeristy Hospital (OUH) in Oslo, Norway. OUH is a third referral hospital, the largest Obstetrics Dept. in Norway, and accounting for 1/6 of all deliveries in Norway (9600 deliveries/year).

Anonymous individual participant data for the primary outcome measures will be made available on request, when the study is finished. Access to data will be restricted due to sensitive nature of the data, but will be shared if asked for within the anonymous data restriction imposed by the patient consent and ethical body approval.

Data will be available on request within 1 year after study completion.

Data access will be considered on specific request. Requestors wil be required to sign a Data Access Agreement.