LABOUR PAIN (FOR PREGANT&NONPREGNANTWOMAN)
INTRODUCTION:THIS IS PROBABLY THE MOST SEVEREST OF ALL PAINS&IS VARIABLE FROM WOMAN TO WOMAN.
OTHER COMPARABLE PAINS:1)SEVERE CONSTIPATION LEADING TO FOECOLITH FORMATION(SMALL STONE LIKE BALLS OF FOECAL MATTER)2)PAIN OF DEFECATION IN HIRSPRUNGS DISEASE(CONGENITAL MEGA COLON) IN EITHER SEX WHERE PERSON PASSES STOOLS ONCE IN 15 DAYS.IT IS A TYPICAL PAIN COMPARABLE TO LABOUR PAINS.3)OTHER PAINS LIKE KIDNEY STONE ,GALLBLADDER STONE,PAINS OF PEPTIC ULCER ETC,ETC,ETC.
ABOUT PAIN IN GENERAL.
THE PERCEPTION OF PAIN ITSELF IS VARIABLE FROM PERSON TO PERSON AS PER THE PSYCHOLOGICAL MAKE -UP,OF THE INDIVIDUAL.IT SHOULD BE UNDERSTOOD THAT HOWEVER PAINFUL THE LABOUR MAY BE IT DOES NOT RESULT IN SHOCK OR DEATH. PROVIDED ALL OTHER CLINICAL PARAMETERS ARE NORMAL OR THERE IS NO OBSTRUCTED LABOUR,LIKE CEPHALO-PELVIC DIS PROPORTION,CORD PROLAPSE,HAND PROLAPSE CORD-AROUND THE NECK,OR COMBINATION OF MORE THAN ONE OF THE ABOVE.ALL THESE CONDITIONS ARE DIAGNOSABLE WELL IN ADVANCE &IS GENERALLY TAKEN UP FOR OTHER MODALITY OF DELIVERY,LIKE CAESAR IAN SECTION.THERE FORE THE PAIN PERCEPTION IS MAINLY AS PER THE 'PSCHE'OF THE INDIVIDUAL.THE WRITTER HAS COME ACROSS TWO EXT REAMS OF EXAMPLES IN HIS LIMIT TED OG PRACTICE.
ONE 18 YR OLD UNMARRIED ANGLO INDIAN LADY WITH ALL ABUSIVE LANGUAGE SCOLDING HER BOY FRIEND(WHO WAS ABSCENT IN THE VICINITY)AT THE HIGHEST PITCH OF HER VOICE,DURING LABOUR PAINS.ANOTHER 25 YR OLD MARRIED LADY WAS ABSOLUTELY SILENT,THOUGH WRITHING IN PAIN&THROUGHOUT TILL THE BABY WAS DELIVERED
NATURE OF LABOUR PAIN: THE ANATOMY &PHYSIOLOGY OF FEMALE GENITAL TRACT IS SUCH THE UPPER PART IS
BULBOUS&LOWER PART NARROW.WHEN UPPER PART CONTRACTS THE LOWER PART DILATES &VICEVERSA.
SOME TIMES UPPER PART ONLY CONTRACTS BUT LOWER PART DOES NOT DILATE&THIS IS THE CAUSE FOR A DIFFICULT LABOUR.THE NERVES RESPONSIBLE FOR PAIN IS IN THE SPINAL CORD&IS SELECTIVELY POSSIBLE TO PARALISE,
THE NERVE BY A SPINAL INJECTION.
FOR ALL FIRST PREGNANCIES,CUTTING THE LOWER PART OF THE GENITAL TRACT UNDER LOCAL ANAESTHESIA IS NORMALLY DONE IN ORDER TO FACILITATE DELIVERY.
THE MAIN REASON WHY A PREGNANT WOMAN IS SCARED IS BECAUSE SHE HAS BEEN CONDITIONED ALREADY BY OTHER EXPERIENCED WOMEN THAT THE PAIN WILL BE SEVERE ENOUGH THAT SHE WILL BE NEARER TO DEATH.THIS IS ONE MAJOR CONTRIBUTING CAUSE FOR A CAESAR IAN SECTION.FIVE DECADES BACK MOST DIFFICULT LABOURS WERE MANAGED BY FORCEPS ONLY..EVEN THIS WRITER HAS COME ACROSS A CASE DURING HIS EARLY YEARS .IT WAS A CASE WHERE !)MEMBRANES RUPTURED OUTSIDE,2)HAND PROLAPSE),3)UMBILICAL CORD PROLAPSE.THIS IS A FITTING CASE FOR CAESAR IAN.AS FACILITIES WERE LIMITTED IT WAS DELIVERED BY FORCEPS SUCCESSFULLY.WITH AN INTERRUPTED CHLOROFORM ANAESTHESIA.BY THE WRITER WITH THE HELP OF THREE NURSES!.
CONCLUSION:LABOUR PAIN IS A SEVERE TYPE OF PAIN,OFTEN WITH FEAR OF DEATH.
WHEN THERE IS NO EFFECTIVE CONTRACTION OR LOW OR NO LOWER SEGMENT DILATATION THE WOMAN IS SUBJECTED TO PERIODIC SPASMODIC PAIN WITHOUT GOOD OUTCOME.HENCE 'PITOCIN DRIP' TO ACCELERATE THE CONTRACTION IS OFTEN SUCCESSFUL.WHEN IT FAILS &IF THERE IS EVIDENCE OF FOETAL DISTRESS, THEN THE CASE IS GENERALLY TAKEN UP FOR CESAREAN&THAT IS ULTIMATE.
TAKE HOME MESSAGE:ALL LABOUR PAINS ARE BEARABLE THOUGH IT IS VERY MUCH AGONISING,PROVIDED THE MIND IS CONDITIONED ALREADY.PRE-DELIVERY CONDITIONING &COUNSELLING ARE MANDATORY.
