One of the number one concerns of pregnant women awaiting their delivery date is the pain associated with labor. Many women who have previously given birth will describe the pain as excruciating, while others describe it as intense, but manageable. Understanding the theories behind pain, may help a woman better understand her ability to control the intensity of the pain she experiences during her labor and delivery.
Rene Descartes, a French philosopher and mathematician presented a theory in the late 16th century stating that the severity and intensity of pain felt was directly related to the severity and intensity of the injury. For example, pricking the finger with a needle or a pin produces minimal pain, while cutting the hand with a knife provides more intense and severe pain. This theory is often considered one of the “original” pain theories and is commonly accepted by most. This theory is generally accurate when related to many injuries and the pain related to these injuries. This theory can be related to birth, however, is less commonly related to birth than the Gate Control Theory and the Fear Tension Pain Cycle Theory.
Gate Control Theory
A new theory regarding pain was introduced in the 1960’s, when scientists Ronald Melzack and Patrick Wall recognized the importance of the mind when it came to the perception of pain. This pain theory is based on the idea that the experiencing pain relies on very complicated interactions between the central nervous system and the peripheral nervous system. When part of the body is injured, pain signals are sent from the cells in the damaged or injured tissue. These signals then travel through the peripheral nerves to the brain. However, before reaching the brain, what Melzack and Patrick labeled as “nerve gates,” open or close depending on various circumstances. Then the “nerve gates” are open at the time the pain signals are sent, the signals easily pass onto the brain, and the pain is then felt more intensely. When these “nerve gates” are closed, these signals have much more difficulty passing through and pain felt is either incredibly lessened, or even eliminated.
Certain factors help to open or close the “nerve gates.” Factors that open the “nerve gates,” allowing pain signals to travel more freely and easily, thus intensifying pain include;
Being preoccupied and concerned with the pain can open the gates making it easier for these signals to travel, thus worsening pain. Having high levels of anxiety over the pain opens the “nerve gates.”
Sensory factors, such as being under the influence of drugs or alcohol, as well as poor physical condition and lack of mobility may open the “nerve gates” allowing pain signals to travel more freely.
Emotional factors can impact the “nerve gates” just as much, if not more than cognitive and sensory factors. Individuals suffering from depression, or anxiety are more likely to have open “nerve gates.” If the individual is incredibly fearful, and feels helpless when it comes to the pain, the gates are much more likely to remain open, making the pain felt more intense.
There are factors that may help to close the “nerve gates” often reducing the intensity of the pain experienced, or eliminating the pain felt entirely. These factors include;
An individual who remains positive about their ability to cope with pain, or uses other methods to distract themselves from the severity of the pain may be able to effectively close the “nerve gates,” reducing the amount of pain experienced.
Avoiding being under the influence of drugs and alcohol, and using relaxation techniques such as breathing patterns, meditations and visualizations may help effectively close the “nerve gates,” lessening the amount of pain experienced.
An individual who maintains a positive attitude and understands that pain is not always a bad thing, and maintains a certain degree of control over themselves and their situation is often able to effectively close the “nerve gates,” reducing the intensity of pain experienced.
Fear Tension Pain Cycle Theory
Dr. Dick-Read developed the Fear Tension Pain Cycle theory in the 1930’s while observing laboring women. Dick-Read believed that labor was not specifically painful, but rather, the pain experienced by women during labor was associated with society’s fear. He observed that in this cycle, when a woman felt fearful during labor, this would trigger the “fight or flight” response, releasing stress hormones into her body. These stress hormones have been known to stall or even stop labor completely. However, in instances where labor is not stopped by this this response, the stress hormones and fear cause tension in the woman’s body, thus amplifying and intensifying the pain she experiences during labor. Sadly, many women go into their labors, fearful and with high stress levels, thus increasing their chances of creating tension in their bodies that will result in further pain.
Pain in labor is often unavoidable, however, it does not necessarily need to be unbearable. With education, practice and determination it may be possible for the woman to lessen the intensity of her pain. Focusing positively on her ability to cope with pain, as well as practicing relaxation techniques may help prevent fear that may bring tension to the body, as well as build a confidence in her ability to birth. These skills can be built on and strengthened by attending childbirth education courses that focus on these skills and improving them in preparation for labor and delivery.
Childbirth International. “Pain in Labor.” Physiology for Birth Manual. Print.
Vanderlaan, Jennifer. “The Fear Tension Pain Cycle.” Birthing Naturally. Web. 19 Sept. 2010.
“The Pain-Coping Mindset.” BirthSource, Information for Babies, Doulas, Childbirth and More. Web. 19 Sept. 2010.
Deardorff, William W. “Modern Theories of Chronic Pain.” Spine-Health. 11 Mar. 2003. Web. 19 Sept. 2010.