MANAGEMENT OF OBSTETRIC DISCOMFORT DURING LABOR
The management of obstetric discomfort during labor is the responsibility of all
nursing personnel. The relief or reduction of pain during labor can be achieved by
several different methods (that is, psychoprophylactic methods, systemic drugs, local
and regional nerve blocks, and general anesthesia). It will be important to you to have
an understanding of where the discomfort originates, the nursing interventions to be
provided, and measures used by the physician to help relieve discomforts experienced
SOURCES OF DISCOMFORT DURING CHILDBIRTH
a. Visceral Discomfort (Abdominal or Internal Organs). This occurs most
often during the first stage of labor. It results from uterine contractions. Discomfort is
felt in the lower abdomen, lumbar region, and thighs. The mother will be free of pain
b. Perineal Discomfort. The greatest discomfort is felt during the second stage
of labor. This is when the cervix is dilating from 8 to 10 cm. Discomfort is due to the
stretching of the vagina and the perineum as the presenting part moves through the
FACTORS THAT MAY INFLUENCE THE AMOUNT OF PAINFUL STIMULI
a. Patient's Pelvic Anatomy Itself. If the patient's pelvic anatomy is large, it
may be easily expandable and if it is small, more stretching and increased
intraabdominal pressure may be required.
b. Fetal Head Size. A large head would require more room and more time to
descend and deliver. A small head may pass through the pelvis with a minimal amount
c. Strength, Frequency, and Duration of Uterine Contractions.
Extremely strong contractions may cause significant discomfort to the
(2) Contractions occurring every two to three minutes may cause the patient
to be fatigued and less tolerable of the discomfort.
(3) Contractions continually lasting sixty to ninety seconds require a great
deal of tolerance and concentration by the patient.