Pain in Childbirth: predictors, correlates, outcome and management
Pain in childbirth receives little research attention. Although it may be seen as a biological imperative, pain experienced in childbirth is a predictable acute pain episode that should be able to be well managed. Just like initial reluctance to use anesthesia in surgery, there seems some opinion that childbirth pain should be tolerated rather than treated. A sample of 137 first time mothers were recruited. They were questioned 4 times: around 24 weeks gestation, pre-birth, post-birth and six month post-partum. Expectations of pain were rated and this was found to have a weak positive correlation with pain experienced.
Women, in general, expected more pain than they went on to experience. Most women used both medical and non-medical treatments to manage the pain. Labour pain experienced was not correlated with previous or later post-natal depression, childbirth self-efficacy, age, trait anxiety or childbirth satisfaction. Pain increased the use of non-medical management more than medical management, which women rated as helpful.
This data set allows presentation of predictors of pain, correlates of pain and outcomes of pain, in addition to the management of pain. Qualitative data to support and explain these findings will be presented along with corresponding data from the womens’ partners. This data may be helpful for practitioners involved in childbirth but also as an interesting sub-set of pain management studies.
Childbirth is both an emotional and painful experience and much is to be learned from examining the intersection of the various contributions to the pain experience.
Updates from Nicola on the project
I recently was lucky enough to gain a small project funding grant from Pain@Otago. I used this money to employ an amazing graduate student Lana. Lana took some pain data that we had collected as part of another project about childbirth satisfaction and analysed it. The data was quite complex and she consulted a biostatistician and made statistical models of what predicted childbirth pain and what outcomes it led to. I took the results to a Behavioural Medicine conference in San Diego earlier this year, where it was well received. I'm busy creating a final draft to submit to a journal. Thanks Pain@Otago!