OBJECTIVE:to investigate factors important to women receiving midwife-led care with regard to their expectations for management of labour pain. DESIGN:semi-structured ante partum interviews and analyses using constant comparison method. PARTICIPANTS:fifteen pregnant women between 36 and 40 weeks gestation receiving midwife-led care. SETTING:five midwifery practices across the Netherlands between June 2009 and July 2010. MAIN OUTCOME:women's expectations regarding management of labour pain. RESULTS:we found three major themes to be important in women's expectations for management of labour pain: preparation, support and control and decision-making. In regards to all these themes, three distinct approaches towards women's planning for pain management in labour were identified: the 'pragmatic natural', the 'deliberately uninformed' and the 'planned pain relief' approach. CONCLUSION:midwives need to recognise that women take different approaches to pain management in labour in order to adapt care to the individual woman.