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Laboring person sitting on a birthing ball.
Figure 17.1 Birthing Ball This laboring person is sitting on a birthing ball to encourage fetal descent and decrease discomfort. (credit: reproduced with permission from Amy Giles)

Pain is the process of signals traveling through nerves to be interpreted by the brain. Every person experiences pain differently, and only that person can explain their pain experience. Research has shown that labor pain has both physiologic and psychologic causes (Beigi et al., 2010; Rúger-Navarrete et al., 2023). In the Berlit et al. (2018) study, laboring persons with fear of and anxiety related to childbirth experienced increased pain. Those persons with a history of sexual trauma had increased pain sensitivity that led to more traumatic births. Other research has shown that being alone increased pain, while having a support person in the room decreased pain (Beigi et al., 2010; Rúger-Navarrete et al., 2023).

The pregnant person typically considers all pain management techniques to determine what they desire during labor and birth. Many persons create a birth plan to provide nurses and health-care providers with a description of their desires during labor and birth. Most childbirth education (CBE) classes discuss pain management options; however, not all pregnant persons or couples create a birth plan or attend CBE classes, and it is the nurse’s responsibility to describe the options available at that facility.

Options for pain management are vast, but they may be limited by the specifics of the labor and/or birthing situation. Some nonpharmacologic pain management options include creating a peaceful environment or using natural comfort measures, such as movement, breathing, massage, and meditation. Pharmacologic options include narcotics, nitrous oxide, and medications to aid relaxation. Anesthetics, such as local, epidural, and pudendal, are also options. Before and after administering the pain management option, a pain assessment scale will be used to determine the current level of pain and if the intervention(s) has (have) adequately treated the pain. Nursing care of the laboring person includes providing education on the choices for pain management, and determining their effectiveness is important in the care of the laboring person.

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