Working With Pain in Labour Flashcards
Pain can increase levels of catecholamines, what can this cause?
Increased cardiac output/HR
Raised blood pressure
Hyperventilation
Decreased uterine blood flow
Decreased uterine contractions
Nausea and vomiting
Delayed bladder emptying
What are some pain behaviours?
Facial expressions
Verbalisations, vocalisations
Body movements
Mood changes
Changes in activity patterns
What can pain perception be affected by?
Past experiences
Cultural learning
Mood and attention
What is meant by gate control?
When the signal travelling to the spinal cord reaches a certain level of intensity, the ‘gate’ opens. Once the gate is open, the signal can travel to the the brain where it is processed, and the individual proceeds to feel pain. Simply stated when the gate closes, the brain does not receive the info that is coming from the periphery to the spinal cord.
What is meant by visceral pain?
Pain related to the inetrnal organs that is perceived in the midline of the body
What is meant by somatic pain?
Pain that occurs in tissues such as the muscles, skin or joints
What is visceral pain caused by in labour?
The uterine contractions, the dilation of the cervix and by the stretching of the vagina and pelvic floor.
What is the body of the uterus served by? (in terms of nerves)
Served by autonomic nerves originating in thoracic 11 and 12 and lumbar 1 verterbrae.
What is Gate control theory in labour by Dekker 2018 and some examples?
If nerves are activated in a non- painful way, at the same time that pain is experienced, this activation blocks the pain signals from reaching the brain e.g.
Massage
TENS machine
Hydrotherapy
What is meant by working with pain and what did Leap 2016 find about continuity of carer in relation?
The working with pain approach is based on the principle that pain is one aspect of the physiology of normal labour
Women who had continuity of carer required less pain relief.
What are some examples of working with pain using psychology, positions and natural therapies
Breathing/ hypnobirthing
Active labour/ positions
Water
Massage
Aromatherapy
Acupuncture
TENS
Sterile water injections
Ice packs.
How can maternal position help with pain?
Changing maternal position and movement potentially reduces sources of pain.
Women wont generally put themselves into an uncomfortable position.
Women experience sig less pain when in vertical position.
What are 3 methods of pahrmalogical pain relief?
Inhalation
Opiods
Epidural
What are advantages of entonox- nitrous oxide and O2
Maternally administerred- effective if used appropriately
Odourless and colourless
Used in waterbirths
What are disadvantages of entonox- nitrous oxide and O2
Vitamin B12 deficiency with overuse-24hrs
Administration may impact on effectiveness
Nausea
