Concept of Pain

Pain and Childbearing

Pain!!! An experience most people have Most common reason for seeking

health care

Statistics hard to find – 9-11% suffer from chronic pain

Pain!!! A protective mechanism Aids diagnosis Psychological – a multidimensional

phenomenon drawing on emotional and sensory experience

Subjective – no objective way of demonstrating pain or its severity

Pain perception and assessment Subjective Depends on life experiences Cultural, society, media Assessment scales

Survival Pain has a survival value Commonly associated with injury Variable

People are born without pain sensitivity – shortens life span

Pain!!! May occur without apparent

cause…absent when physical damage is present…spread from the site of damage…occur in unrelated sites… trouble an area that no longer exists…

Personal pain is just that - personal

The meaning of the word Historically pain was expected and

borne stoically.

Believed to come as a punishment – pain derived from the Latin ‘poena’ meaning punishment/penalty.

A sensation?

Aristotle suggested pain was a sensation

Pain, touch, temperature – contact senses

Sight, hearing, smell – distant senses

A sensation the opposite of pleasure

Florence Nightingale Ahead of her times once again

Identified that both psychology and physiology influenced the experience of pain

A sensation? Arises from many forms of intense

stimulation sufficient to produce tissue damage

Not yet determined beyond doubt that there are specific pathways

Sum of all experiences ?Fetal pain

Pain Curative - Historically limited

treatment except by cure Palliative – 15-20 years interest in

relieving pain during treatment – introduction of pain assessment.

What is pain? Universal Unique Subjective Unpleasant

Difficult to understand or define

McCaffrey

‘Pain is whatever the person says it is and exists wherever and whenever he or she says it does’

Purpose of pain To prevent serious injury To prevent further injury To ensure full recovery

Subjective Linked to psyche Linked to social background Linked to culture

Pain Control Pharmacological Non pharmacological

Pain in Childbirth The use, or not, of analgesia in

labour Variable reactions to pain Effect on the fetus Postnatal pain

Pain in childbirth

Purpose Nesting Home/Hospital Natural Childbirth

Midwives Management Control Support Regulation

Conclusion