Skip to main content

Labour Pain

  • Chapter
  • First Online:
Meanings of Pain

Abstract

Contemporary thinking about pain suggests its ultimate function is more than just to indicate bodily injury, pathology or disease. This would seem especially important in the pain that a woman feels during labour and childbirth. The event of birthing a child is essentially a normal and vital physiological process but the pain women report can be extreme. In addition, it can be quite variable, and the variability cannot be explained by tissue-based factors alone. The variability extends not just to the intensity of the pain but also to its quality and behaviour. Equally variable is the ability for women to cope with the pain associated with childbirth. It can be anticipated that individuals will have differing capacities to cope, but the variability can also be a moment-to-moment proposition for the individual woman. In this chapter we will discuss the idea that the meaning of labour pain to the woman may be more important than its nature or intensity in determining the balance between coping and acopia and in defining her overall experience. In doing so, we will also highlight the limitations in current conceptions of pain that cannot yet fully account for unique occurrences of pain, such as the pain of labour and childbirth.

Capsule Summary: The concepts explored in this chapter emphasise the need to attend to the individual meaning that a woman ascribes to her pain experience during labour. We suggest that by conceptualising labour pain as a productive and purposeful pain, prioritising individualised social support and attending to cognitive and emotional variables that shape a woman’s perception of pain, women may be more likely to have positive experiences of labour pain and less need for pharmacological intervention.

Where it is unavoidable, pain can be transformed into something useable, something which wakes us beyond the limits of the experience itself into a further grasp of the essentials of life and the possibilities within us…This insight illuminates much of the female condition, but in particular the experience of giving birth [1, p. 158].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rich A. Of woman born: motherhood as experience and institution. London: WW Norton; 1995. 274 p.

    Google Scholar 

  2. Corli O, Grossi E, Roma G, Battagliarin G. Correlation between subjective labour pain and uterine contractions: a clinical study. Pain. 1986;26(1):53–60.

    Article  CAS  PubMed  Google Scholar 

  3. Lowe NK. Critical predictors of sensory and affective pain during four phases of labor. J Psychosom Obstet Gynaecol. 1991;12(3):193–208.

    Article  Google Scholar 

  4. Melzack R, Kinch R, Dobkin P, Lebrun M, Taenzer P. Severity of labour pain: influence of physical as well as psychologic variables. Can Med Assoc J. 1984;130(5):579–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Lundgren I, Dahlberg K. Women’s experience of pain during childbirth. Midwifery. 1998;14(2):105–10.

    Article  CAS  PubMed  Google Scholar 

  6. Chuahorm U, Sripichyakarn K, Tungpunkom P, Klunklin A, Kennedy P. Fear and suffering during childbirth among Thai women. Thai J Nurs Res. 2007;11(1):49–61.

    Google Scholar 

  7. Wang E. Requests for cesarean deliveries: the politics of labor pain and pain relief in Shanghai, China. Soc Sci Med. 2017;173:1–8.

    Article  PubMed  Google Scholar 

  8. Beigi NMA, Broumandfar K, Bahadoran P, Abedi HA. Women’s experience of pain during childbirth. Iran J Nurs Midwifery Res. 2010;15(2):77.

    PubMed  PubMed Central  Google Scholar 

  9. The Holy Bible: new international version. London: Hodder & Stoughton; 2015.

    Google Scholar 

  10. Doering K, Patterson J, Griffiths CR. Japanese women’s experiences of pharmacological pain relief in New Zealand. Women Birth. 2014;27(2):121–5.

    Article  PubMed  Google Scholar 

  11. Callister LC, Khalaf I, Semenic S, Kartchner R, Vehvilainen-Julkunen K. The pain of childbirth: perceptions of culturally diverse women. Pain Manag Nurs. 2003;4(4):145.

    Article  PubMed  Google Scholar 

  12. Merskey H. Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 1979;6:249–52.

    Article  Google Scholar 

  13. Williams ACC, Craig KD. Updating the definition of pain. Pain. 2016;157(11):2420–3.

    Article  Google Scholar 

  14. Whitburn LY, Jones LE, Davey MA, Small R. Supporting the updated definition of pain. But what about labour pain? [Comment]. Pain. 2017;158(5):990–1.

    Article  PubMed  Google Scholar 

  15. Cohen M, Quintner J, van Rysewyk S. Reconsidering the international association for the study of pain definition of pain. Pain Reports. 2018;3(2):e634.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rowlands S, Permezel M. Physiology of pain in labour. Baillieres Clin Obstet Gynaecol. 1998;12(3):347–62.

    Article  CAS  PubMed  Google Scholar 

  17. Visser EJ, Davies S. Expanding Melzack’s pain neuromatrix. The threat matrix: a super-system for managing polymodal threats. Pain Pract. 2010;10(2):163.

    Article  PubMed  Google Scholar 

  18. Whitburn LY, Jones LE, Davey MA, Small R. The meaning of labour pain: how the social environment and other contextual factors shape women’s experiences. BMC Pregnancy Childbirth. 2017;17:157.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Olza I, Leahy-Warren P, Benyamini Y, Kazmierczak M, Karlsdottir SI, Spyridou A, et al. Women’s psychological experiences of physiological childbirth: a meta-synthesis. BMJ Open. 2018;8(10):e020347.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Reilly P, Macleod I, Macfarlane R, Windley J, Emery R. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl. 2006;88(2):116–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359(11):1108–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Frank JM, Harris JD, Erickson BJ, Slikker W III, Bush-Joseph CA, Salata MJ, et al. Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review. Arthroscopy: J Arthrosc Relat Surg. 2015;31(6):1199–204.

    Article  Google Scholar 

  23. Whitburn LY, Jones LE, Davey MA, Small R. Women’s experiences of labour pain and the role of the mind: an exploratory study. Midwifery. 2014;30(9):1029–35.

    Article  PubMed  Google Scholar 

  24. Whitburn LY, Jones LE, Davey MA, McDonald S. The nature of labour pain: an updated review of the literature. Women Birth. 2019;32(1):28–38. https://doi.org/10.1016/j.wombi.2018.03.004.

    Article  PubMed  Google Scholar 

  25. Obstetric Analgesia and Anesthesia. Practice bulletin no 177. American college of obstetricians and gynecologists. Obstet Gynecol. 2017;129:e73–89.

    Article  Google Scholar 

  26. Leap N, Anderson T. The role of pain in normal birth and the empowerment of women. In: Downe S, editor. Normal childbirth: evidence and debate. Edinburgh: Churchill Livingstone; 2008. p. 29–47.

    Google Scholar 

  27. Turk DC, Wilson HD. Pain, suffering, pain-related suffering—are these constructs inextricably linked? Clin J Pain. 2009;25(5):353–5.

    Article  PubMed  Google Scholar 

  28. Leap N, Dodwell M, Newburn M. Working with pain in labour: an overview of evidence. NCT New Digest. 2010;49:22–6.

    Google Scholar 

  29. Melzack R. Labour pain as a model of acute pain. Pain. 1993;53(2):117–20.

    Article  CAS  PubMed  Google Scholar 

  30. Hess P. Pain in the obstetric patient. In: Elliott JA, Smith HS, editors. Handbook of acute pain management: informa healthcare; 2010. p. 276–91.

    Chapter  Google Scholar 

  31. Brownridge P. The nature and consequences of childbirth pain. Eur J Obstet Gynecol Reprod Biol. 1995;59:S9–S15.

    Article  PubMed  Google Scholar 

  32. Pan PH. Obstetric pain. In: McMahon S, Koltzenburg M, Tracey I, Turk DC, editors. Wall & Melzack’s textbook of pain. 6th ed. Philadelphia, PA: Elsevier Health Sciences; 2013. p. 772–93.

    Google Scholar 

  33. Newnham EC, McKellar LV, Pincombe JI. Documenting risk: a comparison of policy and information pamphlets for using epidural or water in labour. Women Birth. 2015;28(3):221–7.

    Article  PubMed  Google Scholar 

  34. Dempsey R. Embracing the intensity – celebrating birth as a peak bodily performance. Birth matters. 1998:4–6, 20.

    Google Scholar 

  35. Sanders R. Functional discomfort and a shift in midwifery paradigm. Women Birth. 2015;28(3):e87–91.

    Article  PubMed  Google Scholar 

  36. Buckley SJ. Hormonal physiology of childbearing: evidence and implications for women, babies, and maternity care. Washington, DC: Childbirth Connection Programs, National Partnership for Women & Families; 2015. 225 p.

    Google Scholar 

  37. Whitburn LY, Jones LE, Davey MA, Small R. First-time mothers in Victoria – a pilot cohort study.

    Google Scholar 

  38. Whitburn LY, Jones LE, Davey MA, Small R. Expectations, fears and pain experience: identifying internal and external threats to perceived safety for women in two birthing environments. BMC Pregnancy Childbirth. 2017;17:157.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Karlsdottir SI, Halldorsdottir S, Lundgren I. The third paradigm in labour pain preparation and management: the childbearing woman's paradigm. Scand J Caring Sci. 2014;28(2):315–27.

    Article  PubMed  Google Scholar 

  40. Johnson TR, Callister LC, Freeborn DS, Beckstrand RL, Huender K. Dutch women’s perceptions of childbirth in the Netherlands. MCN Am J Matern Child Nurs. 2007;32(3):170–7.

    Article  PubMed  Google Scholar 

  41. Flink IK, Mroczek MZ, Sullivan MJL, Linton SJ. Pain in childbirth and postpartum recovery—the role of catastrophizing. Eur J Pain. 2009;13(3):312–6.

    Article  PubMed  Google Scholar 

  42. Veringa I, Buitendijk S, de Miranda E, de Wolf S, Spinhoven P. Pain cognitions as predictors of the request for pain relief during the first stage of labor: a prospective study. J Psychosom Obstet Gynaecol. 2011;32(3):119–25.

    Article  PubMed  Google Scholar 

  43. Kraljevic S, Banozic A, Maric A, Cosic A, Sapunar D, Puljak L. Parents’ pain catastrophizing is related to pain catastrophizing of their adult children. Int J Behav Med. 2012;19(1):115–9.

    Article  PubMed  Google Scholar 

  44. Fillingim RB, Edwards RR, Powell T. Sex-dependent effects of reported familial pain history on recent pain complaints and experimental pain responses. Pain. 2000;86(1–2):87–94.

    Article  CAS  PubMed  Google Scholar 

  45. Berentson-Shaw J, Scott KM, Jose PE. Do self-efficacy beliefs predict the primiparous labour and birth experience? A longitudinal study. J Reprod Infant Psychol. 2009;27(4):357–73.

    Article  Google Scholar 

  46. Jonsdottir SS, Steingrimsdottir T, Thome M, Oskarsson GK, Lydsdottir LB, Olafsdottir H, et al. Pain management and medical interventions during childbirth among perinatal distressed women and women dissatisfied in their partner relationship: a prospective cohort study. Midwifery. 2019;69:1–9.

    Article  PubMed  Google Scholar 

  47. Sánchez-Cunqueiro MJ, Comeche MI, Docampo D. On the relation of self-efficacy and coping with the experience of childbirth. J Nurs Educ Pract. 2018;8(6):48.

    Article  Google Scholar 

  48. Rafalovich A. Pain is the club: identity and membership in the natural childbirth community. Qual Sociol Rev. 2016;12(3):100–16.

    Google Scholar 

  49. Lang AJ, Sorrell JT, Rodgers CS, Lebeck MM. Anxiety sensitivity as a predictor of labor pain. Eur J Pain. 2006;10(3):263–70.

    Article  PubMed  Google Scholar 

  50. Curzik D, Jokic-Begic N. Anxiety sensitivity and anxiety as correlates of expected, experienced and recalled labor pain. J Psychosom Obstet Gynaecol. 2011;32(4):198–203.

    Article  PubMed  Google Scholar 

  51. Costa-Martins JM, Pereira M, Martins H, Moura-Ramos M, Coelho R, Tavares J. The role of maternal attachment in the experience of labor pain: a prospective study. Psychosom Med. 2014;76(3):221–8.

    Article  PubMed  Google Scholar 

  52. Quinn K, Spiby H, Slade P. A longitudinal study exploring the role of adult attachment in relation to perceptions of pain in labour, childbirth memory and acute traumatic stress responses. J Reprod Infant Psychol. 2015;33(3):256–67.

    Article  Google Scholar 

  53. Ballantyne JC, Sullivan MD. Discovery of endogenous opioid systems: what it has meant for the clinician’s understanding of pain and its treatment. Pain. 2017;158(12):2290–300.

    Article  CAS  PubMed  Google Scholar 

  54. Forster DA, McLachlan HL, Davey MA, Biro MA, Farrell T, Gold L, et al. Continuity of care by a primary midwife (caseload midwifery) increases women’s satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial. BMC Pregnancy Childbirth. 2016;16(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kildea S, Hickey S, Nelson C, Currie J, Carson A, Reynolds M, et al. Birthing on country (in our community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting. Aust Health Rev. 2018;42(2):230–8.

    Article  PubMed  Google Scholar 

  56. Leap N, Sandall J, Buckland S, Huber U. Journey to confidence: women’s experiences of pain in labour and relational continuity of care. J Midwifery Womens Health. 2010;55(3):234–42.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laura Whitburn .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Whitburn, L., Jones, L. (2019). Labour Pain. In: van Rysewyk, S. (eds) Meanings of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-24154-4_8

Download citation

Publish with us

Policies and ethics