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Pain is a complex interaction of physiological and psychological responses.

Nociceptive pain Pain caused by actual or potential tissue damage, e.g. a cut, burn or other injury, arthritis, or pressure, e.g. from a tumour; activated or damaged nerve endings send pain messages to the brain. Tends to be sharp or aching.

Neuropathic pain Pain caused by a problem with one or more nerves; pain messages are sent to the brain in the absence of injury or tissue damage. Often described as burning, stabbing or shooting; may be painful pins and needles, or electric-shock like sensations; a light touch may be felt as painful (allodynia), mild discomfort as severe pain.

Pain in labour

Extracted from Myles Textbook for Midwives 15th Edition. Diane M. Fraser, Margaret A. Cooper (Eds). London; Churchill Livingstone: 2009. Courtesy Elsevier.

The discomfort of labour is caused by the descent of the fetal head (or presenting part) further into the pelvis, by pressure on the cervix and the stretching of the vaginal walls and pelvic floor muscles as descent occurs. The large uterine muscle is contracting more strongly, more frequently and for a longer duration as labour progresses, increasing the discomfort felt by the woman.

The biological, psychological, social, spiritual, cultural and educational dimensions of each woman have an impact on how she expresses herself and how she perceives pain during labour. Emotions such as fear and anxiety affect her perception of pain Midwives should work with women to encourage them to maintain control and be as mobile as possible throughout labour. Mobility in labour lessens the need for analgesia. Pain control during labour should be woman-centred not medically oriented. (For pharmacological and non-pharmacological methods of pain control, see Pain control.)

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