2.50
Hdl Handle:
http://hdl.handle.net/10755/150326
Type:
Presentation
Title:
Parity and the progression of pain during labor
Abstract:
Parity and the progression of pain during labor
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Lowe, Nancy, PhD
P.I. Institution Name:Ohio State University College of Nursing
Title:Associate Professor
Data from research and clinical observation support the

consideration of pain as a significant component of the birth

experience for most women. Although pregnant women who have

previously given birth are frequently advised that in all

likelihood the approaching labor will be easier than their first,

research findings do not consistently link subsequent birth with

decreased pain during labor. In a preliminary study by the

investigator, pain scores for multiparous women were significantly

lower during early labor and significantly higher during second

stage than scores of the primiparous subjects. The purpose of this

study was to determine if a differential progression of sensory and

affective pain is reported during four clinical phases of labor by

nulliparous as compared to multiparous women.



The separation of pain into sensory and affective dimensions is

based on the theoretical perspective of the pain literature which

describes pain as an abstract, multidimensional concept. Although

three dimensions were originally proposed (sensory, affective, and

evaluative), the work of Melzack and others related to the Gate

Control Theory and the development of the McGill Pain Questionnaire

supports the discrimination of pain into at least two dimensions

(sensory and affective).



Sixty-five nulliparous and 100 multiparous women at term with

obstetrically normal pregnancies were the subjects for this

descriptive clinical study. The women responded to the Short-form

McGill Pain Questionnaire during early (0-3cm), active (4-7cm),

transitional (8-10cm), and second stage labor. An unbalanced

repeated measures analysis showed a significant main effect for

parity for affective pain; a significant main effect for labor

stage for both sensory and affective pain; and a significant

interaction effect between parity and labor stage for sensory pain.

Although pain scores for both nulliparas and multiparas increased

significantly from early to active labor, similarity in the pattern

of scores was no longer evident as labor progressed. Fornulliparas,

there was no significant increase in scores from activeto

transitional labor, and a decrease in scores from transition to

second stage. In contrast, the scores of the multiparas increased

from active labor to transition and did not decrease significantly

from transition to second stage.



Physiologic differences in the transmission of nociceptive stimuli,

as well as differences in attitudinal sets, such as self-confidence

and fears about labor produced by prior labor experience, may both

function to explain the observed differences in perceived pain

between these two groups of women. Since sensory information has

been found to increase the effectiveness of coping with painful

clinical experiences, the incorporation of these differences in

pain into childbirth education for primiparas and multiparas may

increase the effectiveness of their preparation. This

recommendation, however, warrants further clinical study.



This study was supported by a grant from the National Center for

Nursing Research, NIH, #1 R15 NR01644-01



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleParity and the progression of pain during laboren_GB
dc.identifier.urihttp://hdl.handle.net/10755/150326-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Parity and the progression of pain during labor</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lowe, Nancy, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ohio State University College of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr><td colspan="2" class="item-abstract">Data from research and clinical observation support the<br/><br/>consideration of pain as a significant component of the birth<br/><br/>experience for most women. Although pregnant women who have<br/><br/>previously given birth are frequently advised that in all<br/><br/>likelihood the approaching labor will be easier than their first,<br/><br/>research findings do not consistently link subsequent birth with<br/><br/>decreased pain during labor. In a preliminary study by the<br/><br/>investigator, pain scores for multiparous women were significantly<br/><br/>lower during early labor and significantly higher during second<br/><br/>stage than scores of the primiparous subjects. The purpose of this<br/><br/>study was to determine if a differential progression of sensory and<br/><br/>affective pain is reported during four clinical phases of labor by<br/><br/>nulliparous as compared to multiparous women.<br/><br/><br/><br/>The separation of pain into sensory and affective dimensions is<br/><br/>based on the theoretical perspective of the pain literature which<br/><br/>describes pain as an abstract, multidimensional concept. Although<br/><br/>three dimensions were originally proposed (sensory, affective, and<br/><br/>evaluative), the work of Melzack and others related to the Gate<br/><br/>Control Theory and the development of the McGill Pain Questionnaire<br/><br/>supports the discrimination of pain into at least two dimensions<br/><br/>(sensory and affective).<br/><br/><br/><br/>Sixty-five nulliparous and 100 multiparous women at term with<br/><br/>obstetrically normal pregnancies were the subjects for this<br/><br/>descriptive clinical study. The women responded to the Short-form<br/><br/>McGill Pain Questionnaire during early (0-3cm), active (4-7cm),<br/><br/>transitional (8-10cm), and second stage labor. An unbalanced<br/><br/>repeated measures analysis showed a significant main effect for<br/><br/>parity for affective pain; a significant main effect for labor<br/><br/>stage for both sensory and affective pain; and a significant<br/><br/>interaction effect between parity and labor stage for sensory pain.<br/><br/>Although pain scores for both nulliparas and multiparas increased<br/><br/>significantly from early to active labor, similarity in the pattern<br/><br/>of scores was no longer evident as labor progressed. Fornulliparas,<br/><br/>there was no significant increase in scores from activeto<br/><br/>transitional labor, and a decrease in scores from transition to<br/><br/>second stage. In contrast, the scores of the multiparas increased<br/><br/>from active labor to transition and did not decrease significantly<br/><br/>from transition to second stage.<br/><br/><br/><br/>Physiologic differences in the transmission of nociceptive stimuli,<br/><br/>as well as differences in attitudinal sets, such as self-confidence<br/><br/>and fears about labor produced by prior labor experience, may both<br/><br/>function to explain the observed differences in perceived pain<br/><br/>between these two groups of women. Since sensory information has<br/><br/>been found to increase the effectiveness of coping with painful<br/><br/>clinical experiences, the incorporation of these differences in<br/><br/>pain into childbirth education for primiparas and multiparas may<br/><br/>increase the effectiveness of their preparation. This<br/><br/>recommendation, however, warrants further clinical study.<br/><br/><br/><br/>This study was supported by a grant from the National Center for<br/><br/>Nursing Research, NIH, #1 R15 NR01644-01<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:21:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:21:46Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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