5.1a Pain during Labor and Birth Flashcards
1
Q
Pain During Labor
A
Caused by
- Distension of lower uterine segment
- Stretching of cervical tissue during effacement and dilation
- Pressure against adjacent structures
2
Q
Referred Pain
A
Pain in uterus radiates to
- Abdominal wall
- Lumbosacral area of back
- Iliac area
- Gluteal area
- Thighs
- Lower back
3
Q
Visceral Pain
A
- Uterine ischemia during first stage of labor
- Lower portion of abdomen
4
Q
Somatic Pain
A
- Second stage of labor
- Intense, sharp, burning, well localized
5
Q
First Stage of Labor
A
- Transmitted via T10, T11, T12, L1
- Accessory Lower Thoracic and Upper Lumbar Sympathetic Nerves
- Discomfort only during contractions
- Fetus in posterior position may cause women continuous pain
6
Q
Uterine Ischemia (1st Stage)
A
- Low blood flow and oxygen deficit
- Compression of arteries supplying myometrium during contractions
- Results in visceral pain in lower abdomen
7
Q
Progression of Labor
A
- Somatic pain in late 1st stage and 2nd stage of labor
- Caused by distension and contraction of peritoneum and uterocervical supports.
- Also caused by pressure against bladder, rectum, lacerations of soft tissue
- Pain becomes more intense and persistent as labor progresses
- Patients become fatigued and discouraged
8
Q
Perception of Pain
A
- Subjective, defined completely by patient
Influencing Factors
- Culture
- Age
- Previous personal experience with pain
- Parity
- Physical/psychological/emotional support
9
Q
Physiologic and Sensory Expressions of Pain
A
- Sympathetic nervous system activity due to anxiety, stress, and pain. (Increase catecholamine)
- BP and HR Increase
- RR change due to increased oxygen consumption
- Hyperventilation (alkalosis)
- Decreased placental perfusion
- Diminished uterine activity
10
Q
Affective Expressions of Pain
A
- Increased anxiety and lessened perceptual field
- Writhing (twisting or squirming)
- Crying
- Groaning
- Gesturing (hand clenching and wringing)
- Excessive muscular excitability throughout body
