///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

The Language, Nature and Variability of Women’s Experiences of Physical Pain During Childbirth: A Visually-driven Qualitative Study

Abstract Number: T1D-340
Abstract Type: Original Research

Pamela J Angle MD MSc DPhil (c)1 ; Christine Kurtz-Landy RN, PhD2; Jasmine Djordjevic BSc3; Arthur Zaltz MD FRCPS4

Introduction: Women's experiences of physical pain during childbirth have yet to be meaningfully described in the literature. A more robust understanding of the nature and variability of these experiences and the common language women use to describe them is required to advance understanding of childbirth pain, its measurement, and its treatment.

Methods: This two-phase exploratory descriptive, visually-driven, qualitative study explored/described the nature and variability and common language of women's childbirth pain experiences over the course of labor and delivery. Forty healthy native-English speaking women of mixed parity participated in in-depth, face-to-face interviews during labor and/or early postpartum periods. Phase 1(n=25) explored/described physical pain across a broad spectrum of childbirth experiences; phase 2(n=15) explored the meaning of “back pain” and other pain types identified in women requesting labor epidural top ups. In both phases, women endorsed/generated pain descriptors from a list on a Pictorial Pain Mapping Tool and “mapped” them to pain drawings at 4 time points during labor and delivery. Common pain names were generated for each pain type identified using drawing/descriptor sets and used to develop a Lexicon of Childbirth Pain. Common pain names combined with their patterns and relative pain ratings were used to compare women's experiences and the relative importance of pain patterns over time within context based on clinically important groups (e.g. parity, epidural use, delivery mode).

Findings: An understanding of common physical types of childbirth pain, their multidimensional nature and their patterns over time in individual women, and themes which emerged from multiple contrasts based on parity, epidural use, fetal malposition and delivery mode, produced a broader framework out of which women’s multidimensional experiences of childbirth pain can be understood and used to advance treatment. Findings showed that women experienced multiple different types of physical pain during childbirth; these varied in their presence, severity and associated distress within the same woman and between women over time. Some pain types and patterns were associated with important clinical findings such as fetal position and operative delivery.

Conclusions:Women experience multiple types of physical pain during childbirth. These may be identified using common pain names and their corresponding pain drawing/descriptor sets. Findings suggest that some physical pain types and patterns may be useful in predicting labor outcomes and for targeting pain management/treatment.

SOAP 2019