The aim of this study was to assess women's level of satisfaction with management during labour and to ascertain their preference for mode of delivery. The basis for the findings was the cross-sectional anonymous questionnaire survey of 520 women at a Dublin obstetric hospital. Visual analogue scales were used to assess degree of satisfaction. The response rate was 63% (520 of 830). 98.5% of women had hoped for a vaginal delivery and 1.5% for a Cesarean section. All primiparas had wanted a vaginal delivery. The majority of women were satisfied with their care in labour (65% had a score of > or = 7). Factors significantly associated with high levels of satisfaction were good analgesia during labour (particularly epidural), vaginal delivery, adequate preparation for labour and if personal wishes were listened to by staff. Almost all women have a preference for vaginal delivery. Satisfaction with care in labour is significantly influenced by vaginal delivery, empathetic communication by staff and good analgesia in labour.