Labour Pain essay Order Details/Description

Labour Pain essay

Need Help Writing an Essay?

Tell us about your assignment and we will find the best writer for your paper.

Write My Essay For Me

Order Details/Description

Work on the comments. attach the references you use in pdf format at the end of writing process.

Definition of Pain and Description of Labour Pain

Pain is defined as a bothering sensory feeling or emotional experience and is variably described as irritating, sore, stinging, aching, throbbing, or unbearable feeling (Patel 2010). There are two categories of pain, including nociceptive and neuropathic (Macintyre & Schug 2007). Macintyre and Schug (2007) explained these categories in detail. The first category is nociceptive pain—a common category reported in clinical settings. This type of pain occurs due to trauma, tissue damage or inflammation that stimulates sensory nerve endings called nociceptors. Intense peripheral nociceptive stimuli will increase excitability of the nervous spinal cord, leading to central sensitisation in the presence of subsequent pain stimuli, increased intensity and lower pain threshold. Macintyre and Schug (2007) also described two types of nociceptive pain: somatic and visceral pain. Somatic pain may be experienced as sharp, hot or stinging pain that is localised to the area of injury. Visceral pain is dull, cramping or colicky pain that is poorly localised. Visceral pain can also be referred to other areas, with associated symptoms, such as nausea and vomiting. The second category is neuropathic pain. It results from serious injury or disease of the peripheral or central nervous system. Injury leads to developing central sensitisation and hyper excitability of damaged peripheral nerves. Therefore, the patient may experience sensory loss, motor weakness, bowel or bladder sphincter abnormalities, reflex change, pain in area of sensory loss, alteration in skin colour, temperature and texture, and sweating. The resulting pain often responds poorly to pharmacological treatment (opioids). Neuropathic pain can be a part of acute pain following surgery or serious trauma.

Many authors Baker et al. (2001) agree that labour pain is the most excruciating form of pain is that associated with human childbirth. Wong (2009) highlighted that during childbirth; the first and second stages of labour represent and correspond to two different types of pain. The first type of pain experienced during the first stage of labour occurs due to uterine contractions that lead to dilatation of the cervix. This pain consequently is visceral accounting for sensations from the mechanical distension of the cervix and the lower uterine segment. These sensations are transmitted through the L10 nerve root and are often felt as back pain. The second type of pain is experienced during the second stage of labour that occurs due to accentuated distension of the uterus and cervix plus stretching of the structures of the pelvic floor and decent of the fetal head. Wong (2009) clarified that this type of pain is felt though the distribution of the pudendal nerve.

Mander (2000) and Simkin (2000) pointed out that psychology or the contribution of psychologists had never been considered crucial in the domain of antenatal education when it evolved. Therefore, the field has failed to take advantage of crucial developments in comprehending how the psychological aspects impact the two notable aspects related to birth experiences, experiences linked to fear and pain. It can be gathered that the description of pain during labour may vary from other conditions, where it indicates that pathology and variation need to be considered carefully. They also suggested that some studies describe the essence of childbirth pain despite there existing limited yet contrasting proof to show that the pain during labour differentiates from other severe pain conditions.

Assessment and Management of Labour Pain

The estimated birth rate worldwide in 2014 is 18.7 births/1,000 populations, 255 worldwide births per minute or 4.3 births every second (CIA 2014). This means that the world should be on track to achieve the 2015 Millennium Development Goal to improve maternal care, recognising that women’s experience of child birth pain is a primary step in improving maternal care. Positive birth experiences leave enjoyable and pleasant memories. Transmission of positive pain free stories from women who experienced a peaceful spontaneous birth before will encourage women with their first pregnancy to prefer vaginal birth (Beigi et al. 2010).

Accurate assessment and reassessment of acute pain, such as labour pain, is the key for successful pain management (Breivik et al. 2008). Using a validated and reliable tool is necessary for pain management and satisfying clients. Breivik et al. (2008) indicated that acute pain can be assessed both at rest and during movement using one-dimensional tools, such as the visual analog scale and numeric rating scale. They emphasised that the visual analog scale and the numeric rating scale are equally sensitive and superior to a four-point verbal categorical rating scale. The authors also highlighted that the numeric rating scale from 0–10 (‘no pain’ to ‘worst pain’) is more practical than other scales and can determine the intensity of pain accurately.

Patients are usually asked to rate their pain scores at rest time. Assessment of pain during physical activity, such as mobility and deep breathing, is considered a strong indicator of analgesic efficacy. Therefore, nurses have to score pain both at rest and with activity. They also have to assess pain level during the period of treatment. Frequency of assessment depends on the chosen model of pain relief and client response. Poorly controlled pain indicates the need for frequency of assessment and close observation (Macintyre & Schug 2007; ICSI 2008).

The American Society for Pain Management Nursing (ASPMN) (2012) describes a strategic goal that calls for ‘continuous improvement in the knowledge base of current and future health care providers’ as a clinical education that guarantees effective pain management. The management of labour pain is important in the maternity context of birth. Managing labour pain is complicated and requires assessment, reassessment, and constant observation by midwives. However, three main barriers to successful pain management have been identified (Soyannwo 2010; Mander 2010). Firstly, there is the staff culture of difficulty in dealing with women in pain. This barrier is aggravated by midwives’ intolerance of noisy birth environment. Midwives recognise that pain is one of the basic aspects of the labour process. Based on this reality, it is proposed that midwives tolerate and cope with women and women’s reactions. Midwives should differentiate between acceptable physiological labour pain that requires presence and pathological labour pain that requires pharmacological treatment to prevent unwanted complications. Secondly, the midwives’ knowledge and understanding of the meaning of labour pain is important. If midwives were able to interpret pain, this would facilitate supportive care an