Chapter 16 - Nursing Management of
Pain During Labor & Birth
symptoms of pain in L&D - correct answer- facial tension
- flushing/pallor
- difficulty w/ ability to reason clearly
- increased duration/strength of contractions
- decreased interval between contractions
- increased HR & BP
- hands clenched in fists
childbirth pain vs other pain - correct answerchildbirth pain:
- Part of a normal birth process
- Labor pain is intermittent
- Woman has several months to prepare for pain management
- Is self-limiting and rapidly declines after birth
components of pain process - correct answer- Physiologic- reception by sensory nerves and transmission
to the CNS
- Psychosocial- recognizing pain, interpreting it as painful and reacting to the interpretation
- Pain is subjective and personal
- Differences in each childbirth
factors that influence labor pain - correct answerPain threshold (pain perception):
- The least amount of sensation a patient perceives as painful
Pain tolerance:
- The amount of pain a patient is willing to endure
Sources of pain during labor:
- Dilatation/stretching of cervix
, Chapter 16 - Nursing Management of
Pain During Labor & Birth
- Reduction in uterine blood supply during contraction (tissue ischemia)
- Pressure of fetus on pelvis structure
- Stretching of vagina and perineum
Central nervous system factors:
- Gate control theory- pain is transmitted through small diameter nerve fibers. Therefore, the patient
can be distracted by stimulating large diameter nerve fibers through massage, pressure, and heat/cold
application ("Closing the gate")
- Endorphins- natural body substances similar to morphine, increase during pregnancy and peak during
labor. Explains why women in labor often need smaller amounts of analgesic than expected during a
similar painful experience
Maternal conditions:
- Cervical readiness
- Pelvis
- Labor intensity
- Fatigue
Fetal presentation and position
adverse effects of excessive pain - correct answerPhysiologic effects:
- Physical pain causes fear and anxiety
- Increases maternal metabolic and respiratory rate
Psychologic effects:
- Poorly relieved pain lessens the pleasure of this life event for both partners
- Mother may find it difficult to interact with her infant because she is depleted from painful labor
- Unpleasant memories of birth may affect her response to sexual activity or another labor
- Mother's partner may feel helpless and frustrated when the pain is unrelieved
Pain During Labor & Birth
symptoms of pain in L&D - correct answer- facial tension
- flushing/pallor
- difficulty w/ ability to reason clearly
- increased duration/strength of contractions
- decreased interval between contractions
- increased HR & BP
- hands clenched in fists
childbirth pain vs other pain - correct answerchildbirth pain:
- Part of a normal birth process
- Labor pain is intermittent
- Woman has several months to prepare for pain management
- Is self-limiting and rapidly declines after birth
components of pain process - correct answer- Physiologic- reception by sensory nerves and transmission
to the CNS
- Psychosocial- recognizing pain, interpreting it as painful and reacting to the interpretation
- Pain is subjective and personal
- Differences in each childbirth
factors that influence labor pain - correct answerPain threshold (pain perception):
- The least amount of sensation a patient perceives as painful
Pain tolerance:
- The amount of pain a patient is willing to endure
Sources of pain during labor:
- Dilatation/stretching of cervix
, Chapter 16 - Nursing Management of
Pain During Labor & Birth
- Reduction in uterine blood supply during contraction (tissue ischemia)
- Pressure of fetus on pelvis structure
- Stretching of vagina and perineum
Central nervous system factors:
- Gate control theory- pain is transmitted through small diameter nerve fibers. Therefore, the patient
can be distracted by stimulating large diameter nerve fibers through massage, pressure, and heat/cold
application ("Closing the gate")
- Endorphins- natural body substances similar to morphine, increase during pregnancy and peak during
labor. Explains why women in labor often need smaller amounts of analgesic than expected during a
similar painful experience
Maternal conditions:
- Cervical readiness
- Pelvis
- Labor intensity
- Fatigue
Fetal presentation and position
adverse effects of excessive pain - correct answerPhysiologic effects:
- Physical pain causes fear and anxiety
- Increases maternal metabolic and respiratory rate
Psychologic effects:
- Poorly relieved pain lessens the pleasure of this life event for both partners
- Mother may find it difficult to interact with her infant because she is depleted from painful labor
- Unpleasant memories of birth may affect her response to sexual activity or another labor
- Mother's partner may feel helpless and frustrated when the pain is unrelieved
