The Nature of Pain
I’m doing some reading about research on methods to manage labor pain today, and reviewing an old study:
Niven, C. and Gusbers, G. (1984). A Sudy of labour pain using the McGill Pain Questionnaire. Soc Sci Med, 19(12):1347-1351.
Before I had even gotten to the meat of the study, the authors had my attention with one simple and honest assessment of reality – understanding labor pain is difficult. How can a 5 point or 10 point scale of “pain” really capture the full experience of any woman in labor.
- The pain a woman feels may change over time, even if she does nothing different.
- The pain a woman feels may change as she changes positions, even if nothing physically changes with her contractions or labor.
- The pain a woman feels may or may not continue between contractions.
- The pain a woman feels may be less intense or troublesome than negative emotions or negative thoughts she feels during labor.
- The pain a woman feels may or may not reflect how well she feels she is coping with that pain.
And yet, despite the problems with rating pain on a scale, it is the only “objective” measure many women get to share about their labor experience. Nurses may chart both the “pain” and how well the woman feels she is coping, but again, that misses so many aspects of what the pain experience is.
It makes sense women will tell each other labor rates an 11/10 for pain – if the scale isn’t able to measure the full experience, the actual measurement should be off the scale.