Pain Relief in Labour Flashcards
What is the definition of pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage
Which nervous system serves the uterus?
The autonomic system
Describe the route of a pain nerve impulse from uterus and cervix to the central nervous system
Nociceptive nerve endings (pain receptors) in the uterus and cervix pass through the cervical and uterine plexuses to the pelvic .
From there they travel through the middle hypogastric plexus and the superior hypogastric and then to the lumbar nerves to eventually join the thoracic 10, 11, 12 and lumbar 1.
Pain sensation is transferred along nerve fibres to the spinal cord and then upward tracts to the CNS
Describe the route of a pain nerve impulse from the perenium to the central nervous system
Fibres from the perenium pass through the pudendal nerve into the spinal cord through roots S2, S3 and S4
In which vertebra can early labour pain be felt?
T11 and T12
In which vertebra can pain be felt once labour has progressed slightly?
T10 and L1
In which vertebra can pain be felt through referred pain once the fetal head is descending?
L2 and below
What is the primary cause of pain in the first stage of labour?
Uterine contractions
What are the TWO causes of pain during the second stage of labour?
- Stretching and tearing of tissue
- Pressure on skeletal muscles of the perineum
What is the “pain gate theory”?
A mechanism which prevents the transfer of nerve stimuli from reaching the higher centres of the brain where they will be perceived as pain.
This gate can be closed naturally through relaxation and breathing techniques or through pharmacological pain releif
List FOUR types of behaviour that can be seen by the woman, pre-labour
- Nesting
- Spurts of energy
- Intuitive feelings
- Recognising subtle body changes
List SEVEN types of behaviour that can be seen by the woman, in early labour
- Excited
- Anticipation
- Restlessness
- Nervousness
- Wants to walk about
- Making eye contact
- Needing companionship and distraction
List SEVEN types of behaviour that can be seen by the woman, in established labour
- Avoids conversation
- Rests quietly between contractions
- Becomes passive
- Finds own position
- Often sitting with head resting on arms
- Needing non disruptive support from birth partners
- Develops own pattern of breathing
List SEVEN types of behaviour that can be seen by the woman, in transition
- Sudden changes take place
- Feels out of control
- Wants to go home
- Restless moving around
- Irrational comments
- Maybe angry with birth partner
- Verbalising
List FIVE types of behaviour that can be see by the woman, in the second stage
- Becomes calmers
- Gets a second wind
- Sense of purpose
- Intense concentration
- Feels and looks calmer
