BACKGROUND:
Coping with labour pain is a multidimensional process influenced by physical, emotional, and cultural factors. Assessment tools often focus on pain intensity, but evaluating a woman’s coping ability may offer a more holistic perspective. The Pain Coping Scale “3R” assesses coping based on relaxation, rhythm, and ritual.

OBJECTIVES:
To estimate the inter-rater reliability of the Pain Coping Scale “3R” when used by midwives to assess women’s coping ability during different phases of labour.

METHODS:
A cross-sectional study was conducted through an online platform. A total of 59 Italian midwives with experience in intrapartum care assessed 15 short videos showing labouring women during three phases of labour: active first stage, passive second stage, and active second stage. After each video, participants completed the Pain Coping Scale (range 0–10), based on observed behaviours. Intraclass Correlation Coefficient (ICC) was calculated to assess agreement between raters.

RESULTS:
A total of 885 Pain Coping Scales were completed. The midwives showed excellent agreement in assessing coping across all labour phases, with ICCs of 0.992 in the active first stage, 0.993 in the passive second stage, and 0.986 in the active second stage (all p < 0.001). The active second stage showed slightly more variability, likely due to the dynamic nature of this phase and the onset of active pushing. Overall, midwives consistently identified both high and low levels of coping.

CONCLUSIONS:
The Pain Coping Scale “3R” demonstrated excellent inter-rater reliability and may be a useful tool for midwives to assess coping with pain in labour.

KEY MESSAGE:
This tool may contribute to more individualised care, encourage the use of non-pharmacological approaches, and support informed decision-making among women. Poster session 1 (Group A)