Memory of Labor Pain Influenced by a Woman's Childbirth Experience
By Megan Rauscher
NEW YORK (Reuters Health) Mar 11 - Research shows that for about half of women who give birth, memories of the intensity of labor pain decline over time. However, for some women, their recollection of pain does not seem to diminish and for a minority, their memory of pain increases with time.
The study also shows that the memory of childbirth pain is influenced by a woman's overall satisfaction with her labor experience.
Dr. Ulla Waldenstrm, from the Department of Woman and Child Health at the Karolinska Institute, Stockholm, and colleagues queried 1383 mothers about their memories of labor pain at 2 months, 1 year and 5 years after giving birth. Women who underwent elective cesarean section were excluded.
Five years after the women had given birth, 49% remembered childbirth as less painful than when they rated it 2 months after birth, 35% rated it the same, and 16% rated it as more painful.
"A commonly held view," Dr. Waldenstrm noted in an email to Reuters Health, "is that women forget the intensity of labour pain. The present study...provides evidence that in modern obstetric care, this is true for about 50 percent of women."
However, a woman's labor experience was an influential factor. Women who reported labor as a positive experience 2 months after childbirth had the lowest pain scores, and their memory of the intensity of pain had declined by 1 year and 5 years after giving birth.
"Memory of labor pain declined during the observation period but not in women with a negative overall experience of childbirth," the team notes in the March issue of BJOG: An International Journal of Obstetrics and Gynaecology.
Roughly 60% of women reported positive experiences and less than 10% had negative experiences. For women who said that their childbirth experience was negative or very negative, on average, their assessment of labor pain did not change after 5 years.
"A woman's long-term memory of pain is associated with her satisfaction with childbirth overall," Dr. Waldenstrm said, summing up. "The more positive the experience, the more women forget how painful labour was. For a small group of women with a negative birth experience, long-term memory of labour pain was as vivid as 5 years earlier."
The researchers also found that women who had epidural analgesia remembered pain as more intense than women who did not have an epidural, suggesting, they say, that these women remember "peak pain." However, their perception of how painful labour had been also declined with time.
Dr. Waldenstrm and colleagues suggest that healthcare professionals take into account a woman's overall experience with childbirth when assessing whether a woman needs further support postnatally.
BJOG 2009;116:577-583.
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9 comments:
I'd be curious to know how much of this is "cause and effect" and how much is "effect and cause." I can easily see that if a woman is satisfied with her childbirth experience, then she would think about the positives, so diminishing whatever amount of pain she may have gone through; but I can also easily see that if a woman was in severe pain, she would not be satisfied with her birth experience.
What was discovered in this research mirrors my own experience. In my first birth, I felt well supported (planned home-birth with CNM & doula); and while the contractions were painful, I was able to cope with them and manage them just fine, and felt so empowered in the birth. My second labor, I was not supported at all (it was a planned home birth and I didn't call the midwife in time because the contractions were sporadic; and my husband was also away from home), and my contractions were a lot worse than I remember my first labor being. After the second birth, I was just relieved the whole thing was over, not "empowered" in the slightest.
Still, I believe my current feelings to be similar to my past feelings. Immediately after giving birth the first time, I felt like it was "no big deal" and that as long as I was physically fine, I wouldn't be upset if I had to give birth again in just a few weeks. My younger son is almost three years old, and I am just now getting the point where I sometimes think about getting pregnant -- and am still hesitant about it, at least partly because of the way I feel about my second labor. Often I wonder how I would feel about it if I had been supported during labor.
-Kathy
This isn't terribly surprising to me. The research showing that patients that have had a well-controlled pain experience previously are much easy to control pain in the next time around, has been around for a few years now.
It's a natural translation to child birth in my mind.
To me the L&D industry is going to have to drastically revamp the way they conduct births as patient education continues to explode...
hmmm... I had a negative birth experience with my 2nd. baby, but I still forgot the pain. I forgot just how painful the last two babies were until I read my re-read my journal entry from the day after my last daughter's birth! I thought about sharing that entry on my blog, but was afraid it might scare mom's to be rather than encourage them.
So I'm going to disagree. I think some people choose to dwell on the pain and others tend to block painfull experiences out and move on. Regardless of epidural, positive birth experience or negative birth experience.
With birth, I think you always remember that it was painfull, but forget just how painfull it was until something jogs that memory.
There is a new program at a local hospital here that provides trained volunteer 'crisis counselors' for trauma patients who are admitted to the hospital. I *wish* they had a similar program for mothers who have traumatic birth experiences.
With my first birth I had a very unexpected c-section (wasn't planning one at all, much less at 37 weeks!). My OB KNEW I was planning an unmedicated birth, and yet I was cut open and then dumped in a room without anyone to talk to.
I sure could have used "further support postnatally".
Both my labors and deliveries were easey peasey. My sons are 16 and 12....however I do remember! I don;t know that I exactly remember the pain itself, or the fact that I know I was in pain. If that makes any sense. I received one dose of stadol with the first, and nothing else. Total from beginning to end, 7 hours of labor, 30 mins pushing. Second time around I laid on that bed in a complete state of mind-over-matter and finally after three hours asked if they were ever going to give me anything. Of course they had to check, and it was one of those "oopsy, you're too far along...at 9!" Total on this about 5 hours, 15 mins pushing. Let me tell you if (IF-and it ain't gonna happen) I were ever to go through it again I would make sure an epidural was part of my birth plan.
Cervix
We have soooo much work to do to revamp the whole system in the United States. Why can't we make a system where patients feel satisfied with their treatment. And not just laboring women but all patients?
I have been thinking lately of Doctor and Nurse burn out and how that effects the patient. Some Nurses and Docs are just real bastards to the patient. That sucks! Many more women would be satisfied with their experience if we could get our Sh1t together and have 1:1 care of women in labor.
One thing I noticed was that women who went through awful pain in childbirth at the hospital I used to work with, were very satisfied when you asked them," Hey how did your labor go?" I was shocked to hear how wonderful they thought their labor was even though I saw them go through horrible pain! The difference I think was that they had a nurse by their side the whole time.
Well enought from me. Keep fighting the good fight and don't let the man get you down.
Immediately after my births I said in my head, "I CAN NEVER DO THIS AGAIN". It isn't much the labor, but the soreness in the girlie parts afterward.
Today I have four children and willing to have another one (once the eight month old sleeps through the night).
For my friends who are having their first, I tell them don't think about another baby immediately giving birth. Just care for this one.
Don't think about having another baby when you're up 3am at night with a 6 month old either.
Naturally the possibility of a baby grows on you, once you're in your right mind with a good night's sleep.
I had two non-medicated births and my perception of my labor pain is very minimal. I think it had alot to do with my hospital. I live in a small town and our hospital is so accomodating. I was not required to have an IV and they brought me food during my labor. Graham crackers, juice, muffins. I walked the halls, took showers. I ended up giving birth completely naked with my first(not draped in a haz-mat suit) like you see on TV.
I truly believe having the proper support helps with how one perceives their labors.
I went PROM with #1 back labor for 79 hours no epidural till to exhausted to cope any longer.
When #2 was prom, I knew I could not put myself through that again.
I know I could cope if I had fast labors without the back labor. But Alas It's not meant to be.
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