# data[].attributes.body
Periodically re-assess the effectiveness of pain management strategies, the need to modify pain relief, and be timely with interventions to prevent breakthrough pain. The patient must verbalize the pain is controlled and under their pain tolerance limit on a scale of 0-10, 10 being the worst pain.

# data[].attributes.body
Techniques used to manage the pain of labor vary according to geography and culture.

# data[].attributes.body
Morphine:
-Assess level of consciousness, BP, pulse, and respirations

Fentanyl:
-Monitor respiratory rate and BP frequently
-Caution patient to change positions slowly to minimize orthostatic hypotension

# data[].attributes.body
Conscious breathing gives the mother power when engaging in contractions. Effective techniques produce relaxation, pain relief, and redirection of focus onto their breathing. This also promotes adequate oxygenation for not only the mother, but the fetus, considering contractions temporarily halt perfusion and oxygenation to the fetus. Promote slowed breathing, inhaling through the nose, exhaling through pursed-lips, and aiming for 6-9 breaths a minute if able.

# data[].attributes.body
This is a technique of visualization or guided imagery that redirects and distracts the patient's focus from painful stimuli. This may include tactile stimuli, listening to music, imagining being on vacation, happy memories, or even focusing on imagining what is physically occurring as the cervix is dilating and labor progresses. This may not completely distract senses of pain, but it helps keep sensory input from reaching the pain center of the cortex.

# data[].attributes.body
Morphine:
-maternal/fetal CNS depression
-decreased uterine contractions

Fentanyl:
-maternal hypotension
-maternal/fetal respiratory depression

# data[].attributes.headline
What Influences Pain During Labor  (Psychological Factors) 

# data[].attributes.subject
What Influences Pain During Labor  (Psychological Factors) 

# data[].attributes.body
- Pervious experience with pain
- Fatigue
- Pain anticipation
- Genetics
- Positive or negative support system
- HCP's presence & encouragement
- Labor & birth environment
- Cultural expectations
- Level of emotional stress & anxiety

# data[].attributes.body
Benefits:
- Self-administered
- Safety mechanism: impossible to overdose
Potential side effects:
- N&V
- dizziness and dysphoria (rare)

# data[].attributes.body
Use of heat can minimize chills or trembling, joint stiffness, muscle spasms, and promote connective tissue extensibility. Cold therapy relieves muscle spasms and reduces inflammation or edema, but keep in mind that the use of cold therapy is not sufficient enough to reduce labor pain. Maintain safety precautions of having a cover on the heat/cold source, to prevent direct contact causing things like skin burns.

# data[].attributes.body
Nitrous oxide (50%) + Oxygen (50%)

# data[].attributes.body
These require the skills of a trained, certified clinician, in which key trigger points of the body are slightly penetrated with needles, or the pressure of one's fingers, trying to regulate a flow of energy through all the body systems. This also releases endorphins to reduce the perception of pain.

# data[].attributes.body
This is the external use of water to promote health and body relaxation. When soaking in a regular tub or whirlpool, the warm shower releases muscle tension, promotes vasodilation, and a reduction of catecholamines; however, be sure the temperature does not exceed that of the mother's body temperature, and monitor for s/s hypo-/hyperthermia.

# data[].attributes.headline
What Influences Pain During Labor  (Physiological Factors) 

# data[].attributes.subject
What Influences Pain During Labor  (Physiological Factors) 

# data[].attributes.body
- Cervical Stretching
- Hypoxia of the uterine muscle d/t dec. perfusion during contraction
- Pressure in the urethra, bladder, and rectum
- Distention of the muscle of the pelvic floor

# data[].attributes.body
The patient and family will need constant emotional, physical, and informational support, considering childbirth being a life-changing experience. This may include helping formulate a birth plan, or providing words of affirmation. It is best to provide a high-touch, low-tech approach in nursing, so patients can sense a true therapeutic connection with their nurse, and feel that they really care to help them obtain optimal health.

# data[].attributes.body
- Can cause hypotension
- Frequent BP checks
- Frequent position changes
- Dermatome checks
- Urinary catheter
- Limit food, fluids to prevent aspiration
- Coaching for pushing

# data[].attributes.body
Benefits:
- Allows the patient rest
- Improves coping and ability to follow directions
- More enjoyable birth experience
- Can allow for labor progress
Risks:
- Can be one-sided
- Can slow labor
- Can make pushing more difficult
- Spinal headache, back sorness

# data[].attributes.body
Frequent position changes help change the position and shape of the pelvic joints, assisting the fetus to shift around through the birth canal. Other positions allow for better rest, can have the same benefits as ambulating, provide rhythmic movements to provide relaxation and comfort, and utilize gravity to help the fetus descend towards the pelvic outlet.

# data[].attributes.body
Non-pharmacological measures are inexpensive, simple, and safe alternatives before depending on medications for pain relief.

These methods provide a gate control theory of pain, in which other forms of bodily stimulation interfere with transmission of pain stimuli from the spinal cord reaching the brain.

Although not all of these methods may completely eradicate the sense of pain, and are mostly effective for mild-moderate pain, they at least allow the patient to sense feelings of control, especially during labor contractions.

# data[].attributes.body
Advantages:
-Takes the edge off

-Allows the patient to relax/rest

-Allows time for coping education

Limitations:
-Side effects like nausea

-Doesn’t work as well after 2 doses

-Can’t give close to delivery

# data[].attributes.body
Vistaril 50-100 mg orally
Morphine 10 mg IM
Fentanyl 50-100 mg IV

# data[].attributes.body
- Continuous labor support
- Hydrotherapy
- Ambulation and position changes
- Acupuncture, acupressure
- Application of heat and cold
- Attention focusing and imagery
- Breathing techniques

# data[].attributes.body
- She is afraid of how bad the pain will get.
- Anxiety

# data[].attributes.body
- Pain management with epidural once 5cm dilated
- Labor induction with Pitocin; increase every 30 minutes for strong UC every 2-3 minutes
- Foley balloon is inserted for cervical ripening

# data[].attributes.body
- Primipara @ 41.2 weeks gestation
- Afraid of "how bad the pain will get"