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So What CAUSES Labor Pain?And What Can You DO About It?
Linda J. Smith, BSE, FACCE, IBCLC
CEA Orange CountySeptember 2011
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Causes of labor pain
• Muscle pain from the contracting uterus
• Bone pain from the baby moving thru the pelvis
• Tissue pain from stretching• Medical procedures – IV, monitors,
exams• Other?
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Causes of Muscle Pain
• Inadequate fluid intake– A dehydrated muscle tends to cramp
• Inadequate calorie intake (glycogen)– Energy diverted to other muscle groups
deprives the uterus of energy–Muscles starved for energy tend to weaken,
cramp and/or contract ineffectively
• Inadequate oxygen intake– Screaming, breath-holding, chest
constriction
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Solutions for muscle pain
• Fluid intake, preferably oral– ACOG position 2009
• Calorie intake, preferably easy-to-digest carbs and protein sources
• Oxygen intake: keep breathing!• Keep other muscle groups “out of
the way”–Use props, equipment – Conscious release of limbs, torso
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PRACTICE TIME DEALING WITH MUSCLE PAIN
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Causes of Bone Pain
• Cardinal movements of baby– Pressure on sacrum from the inside
• Malpresentation increases mechanical force on pelvic bones
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Solutions to Bone Pain
• Gravity still works• Movement (yours)• Counterpressure on sacrum–What mom can do–What a partner/helper can do
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PRACTICE TIME DEALING WITH BONE PAIN
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Causes of tissue pain
• Unfamiliar sensation • Uncontrollable sensation• Lack of hydration• Lack of lipids in diet (?)
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Solutions to Tissue Pain
• Gentle massage • Lubrication• Knowledge of what to expect and
duration
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PRACTICE TIME DEALING WITH TISSUE PAIN
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Causes of Pain from Procedures
• Needles piercing the skin• Belts constricting the belly / uterus• Attendant’s hands during exams
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Solutions to Procedural Pain
• Negotiate ahead of time!• “And what are the other options?”• Topical pain relief for needle sticks• Intermittent monitoring• Limit exams
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PRACTICE TIME DEALING WITH PROCEDURAL PAIN
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Summary
• Muscle pain is predictable, has remedies
• Bone pain is predictable, has remedies
• Tissue pain is predictable, has remedies
• Procedural pain can be reduced, has remedies
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THANK YOU!