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CHILDBIRTH PAIN: NATURE AND INTENSITY
- The 50% and 80% of pregnant women experience moderate or severe pain during labour.
- There is no evidence that labour pain is beneficial to the mother or the foetus, quite the opposite.
- In 2004, the American College of Obstetrics and Gynecology (ACOG) stated that childbirth pain in itself constitutes a clear indication for the use of analgesic techniques to achieve satisfactory pain relief for pregnant woman beyond any other type of medical consideration.
The onset of pain during labour is linked to the intensity of uterine contractions and to changes in the distensible structures of the birth canal in which they take place during dilation and descent.
Pain in the 1st stage
Period from the beginning of labour to complete dilation. Visceral pain: dull, diffuse and due to the distention and stretching of the cervix and the lower uterine segment during contractions.
The pain is initially located in the hypogastrium, iliac fossa and lower back area.
Presentation positon at the beginning of the first stage
As labour progresses, the contractions become more intense, the pain's intensity gradually increases and spreads to the infraumbilical, upper back and sacral areas.
Pain in the 2nd stage
- Period ranging from full dilatation until foetal expulsion
- The pain is caused by the distention and stretching of the lower part of the birth canal, vulva and perineum caused by the pressure exercised on these structures in foetal presentation
- The pain is localised at the bottom of the sacrum, anus and perineum and sometimes even in the legs
- Somatic pain: acute, intense and clearly localised
Presentation position at the beginning of the second stage
End of the second stage. Foetal expulsion
Pain transmission routes during labour: yellow (stage 1); Blue (transitional stage); red (stage 2)