So What CAUSES Labor Pain?And What Can You DO About It?

Linda J. Smith, BSE, FACCE, IBCLC

CEA Orange CountySeptember 2011

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?

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

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

PRACTICE TIME DEALING WITH MUSCLE PAIN

Causes of Bone Pain

• Cardinal movements of baby– Pressure on sacrum from the inside

• Malpresentation increases mechanical force on pelvic bones

Solutions to Bone Pain

• Gravity still works• Movement (yours)• Counterpressure on sacrum–What mom can do–What a partner/helper can do

PRACTICE TIME DEALING WITH BONE PAIN

Causes of tissue pain

• Unfamiliar sensation • Uncontrollable sensation• Lack of hydration• Lack of lipids in diet (?)

Solutions to Tissue Pain

• Gentle massage • Lubrication• Knowledge of what to expect and

duration

PRACTICE TIME DEALING WITH TISSUE PAIN

Causes of Pain from Procedures

• Needles piercing the skin• Belts constricting the belly / uterus• Attendant’s hands during exams

Solutions to Procedural Pain

• Negotiate ahead of time!• “And what are the other options?”• Topical pain relief for needle sticks• Intermittent monitoring• Limit exams

PRACTICE TIME DEALING WITH PROCEDURAL PAIN

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

THANK YOU!