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• Respiratory:
hyperventilation, leading to hypocapnia and
respiratory acidosis.
• Cardiovascular:
increases cardiac output and blood pressure
via sympathetic activity; Increased venous
return
• Neuroendocrine:
increases maternal catecholamine secretion
with risk of uteroplacental constriction.
CONSEQUENCES OF LABOR PAIN
• Gastrointestinal:
delayed emptying and increased acid
secretion
• Psychological:
long-term emotional stress, with potential
adverse consequences on maternal
mental health and family relationships.
BENEFITS
• Indicates to the mother and those
assisting labor/delivery that contractions
are occurring.
• May have positive connotations regarding
childbirth, related to societal/cultural
influences.
• May indicate problems (e.g. uterine
rupture, placental abruption).
PAIN THEORY
Specificity theory
This theory proposed that a specific system of
nerves carry messages from pain receptors in the
skin to a pain centre in the brain and that the
intensity of the pain is correlated to the amount of
tissue damage
Pattern theory
The most important feature of pain is the amount of
stimulation (tissue damage, injury)
Gate control theory
Stimulation in
C fiber(pain
fiber) open the
gate, causing
pain
Gate control theory
Stimulation in
Aβ fiber
(sensory
nerves) close
the gate,
causing pain
reduced
Natural Labor Pain management
• Counter Pressure
• Environmental Conditions
• Breathing Techniques
• Water
• Birthing Aids
• Vocalization
• Visualization
• Emotional Support
Counter Pressure
• Lamaze
controlling deep breath and muscle
relaxation
• Bradley
controlling deep breath with aid from
husband
Vocalization
• Effleurage Method
• Hypnosis
• Acupressure
• Aroma therapy
Pharmacology Technique
• Pain relief with a narcotic such as meperidine,
plus one of the tranquilizer drugs such as
promethazine, is usually appropriate.
• PUDENDAL BLOCK
• PARACERVICAL BLOCK
• SPINAL (SUBARACHNOID) BLOCK.
• EPIDURAL ANALGESIA.
• COMBINED SPINAL-EPIDURAL
TECHNIQUES.
• General anesthesia
Analgesia & Anesthesia
Pudendal block
Subarachnoid block
Epidural anesthesia
References
• Lowe N. The nature of labor pain. Am J Obstet Gynecol
2000; 186:S16–24.
• J. Edmond Charlton, Core Curriculum for Professional
Education in Pain, IASP Press, Seattle, © 2005.
• F. Gary Cunningham...[et al.]. 22nd ed. Williams
obstetrics © 2005
• Smith CA, Collins CT, Cyna AM, Crowther CA.
Complementary and alternative therapies for pain
management in labor. Cochrane Database of Systematic
Reviews 2006
• Youngkin, Marcia Szmania Davis.3rd ed Women's
health: a primary care clinical guide © 2004
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