Background: The pain experience associated with labour is complex. Literature indicates psychosocial and environmental determinants of labour pain, and yet methods to support women usually target physiological attributes via pharmacological interventions.
Aim: To provide an update of our understanding of labour pain based on modern pain science. The review aims to help explain why women can experience labour pain so differently - why some cope well, whilst others experience great suffering. This understanding is pertinent to providing optimal support to women in labour.
Method: A literature search was conducted in databases Medline, Cumulative Index to Nursing and Allied Health Literature and PsycINFO, using search terms labor/labour, childbirth, pain, experience and perception. Thirty-one papers were selected for inclusion.
Findings: Labour pain is a highly individual experience. It is a challenging, emotional and meaningful pain and is very different from other types of pain. Key determinants and influences of labour pain were identified and grouped into cognitive, social and environmental factors.
Conclusion: If a woman can sustain the belief that her pain is purposeful (i.e. her body working to birth her baby), if she interprets her pain as productive (i.e. taking her through a process to a desired goal) and the birthing environment is safe and supportive, it would be expected she would experience the pain as a non-threatening, transformative life event. Changing the conceptualisation of labour pain to a purposeful and productive pain may be one step to improving women's experiences of it, and reducing their need for pain interventions.
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ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.
Eur J Anaesthesiol
February 2025
From the Servicio de Anestesia y Reanimación, Hospital Universitario Gregorio Marañón, Calle de O'Donnell, 48, 28009 Madrid, Madrid, Spain (NB), the Servicio de Anestesia, Hospital Universitario Sanitas La Zarzuela, Madrid, c/ Pleyades, 25, 28023 Madrid, Spain (NB), the Servicio de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, P° de la Castellana, 261, 28046 Madrid, Spain (IVG), the Department of Paediatric and Obstetric Anaesthesiology, Juliane Marie Centre, Rigshospitalet & Institute of Clinical Medicine, University Hospital of Copenhagen, Copenhagen, Denmark (AA, KL), the University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany (PK, SR), the Division of Anesthesia Critical Care and Pain, Tel Aviv Sourasky Medical Center affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv Israel (CFW), the London North West NHS University Trust, Watford Road, London, UK HA1 3UJ (NL), the Department of Anesthesia & Intensive Care Medicine, Liège University Hospital, Belgium (PYD), the Servicio de Anestesia y Reanimación. Hospital Universitario Fundación Jiménez Díaz. Av. de los Reyes Católicos, 2. 28040 Madrid. Spain (EGA), the Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Shmuel Beyth St 12, Jerusalem, 9103102 Israel (AI), the Department of Anesthesia and Intensive Care, Akademiska Sjukhuset, Sjukhusvägen, 75185, Uppsala, Sweden (AK), the Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel affiliated with Tel Aviv University Medical School (SOZ), the Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (OvdB), the Department of Cardiovascular Sciences, KU Leuven, and Department of Anaesthesiology, UZ Leuven, Belgium (MvdV), the Department of Anaesthesia, Intensive Care and Pain Medicine, University General Hospital of Valencia, Methodology Department, European University of Valencia, Valencia, Spain (CSR).
Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.
Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.
Insufficient Labor Epidural Analgesia Due to Asymptomatic Sacral Perineural Cyst: A Case Report.
Cureus
November 2024
Department of Anesthesiology, Adachi Hospital, Kyoto, JPN.
Lumbar epidural anesthesia is widely used for labor epidural analgesia (LEA), but it often results in insufficient analgesia in the sacral region. We report a case where we performed LEA using lumbar epidural anesthesia, and an asymptomatic sacral perineural cyst was considered the potential cause of inadequate analgesia in the sacral region. A 33-year-old primigravida was admitted with premature rupture of membranes.
View Article and Find Full Text PDFThe effect of dance and massage applied by spouses during childbirth on labor pain, comfort, and satisfaction.
Eur J Obstet Gynecol Reprod Biol
December 2024
Kirklareli University School of Health Science, Midwifery Department Kirklareli, Turkey. Electronic address:
Objective: The aim of this study is to evaluate the effects of endorphin massage and dance applied by spouses during labor on labor pain, satisfaction with childbirth, postpartum comfort, and person-centered maternity care.
Materials And Methods: The sample of this randomized controlled experimental study consists of 105 pregnant women in their second childbirth (35 in the birth dance group,35 in the endorphin massage group, and 35 in the control group). The endorphin massage taught by the researcher to the pregnant women and their spouses was applied for 10 min.
Investigating the association between labor pain and cessation of breastfeeding.
Sci Rep
December 2024
Department of Women's Anesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Mothers encounter several challenges to sustain breastfeeding until the recommended 6 months of age. There is limited evidence on the impact of women's labor pain experiences upon cessation of breastfeeding. We aimed to investigate the association between women's labor pain experiences, intrapartum interventions, and pre-birth psychological vulnerabilities and cessation of breastfeeding.
View Article and Find Full Text PDFDevelopment and validation of a prediction model for intrapartum fever related to chorioamnionitis in parturients undergoing epidural analgesia.
Sci Rep
December 2024
Department of Anesthesiology, Sichuan Women's and Children's Hospital/Women's and Children's Hospital, Chengdu Medical College, Chengdu, 610000, China.
Intrapartum fever is a common complication in parturients undergoing epidural analgesia (EA), significantly increasing the incidence of maternal and infant complications. This study aims to develop and validate a prediction model for intrapartum fever related to chorioamnionitis (IFTC) in parturients undergoing epidural analgesia. A total of 596 parturients with fever (axillary temperature ≥ 38℃) who received EA from January 2020 to December 2023 were included and randomly assigned to the training set (N = 417) and the validation set (N = 179) according to the ratio of 7:3.
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