Paradigm of pain in the birth sphere

This chapter addresses the paradigm of pain in labour and the part that mindfulness may play in supporting women in their experience and perception of pain. Labour pain and its meaning are explored as well as how labour pain has a critical difference from other forms of pain. An overview and breakdown of current pain definitions and theoretical frameworks are introduced to situate the concept of labour pain. The question of how current conceptions of pain are laying the foundation for women’s expectations of labour pain and how it should be managed are addressed. An outline of how the physiology of labour and the role of pain during this phase relates to a neurohormonal cascade (oxytocin, endorphins, adrenalin etc) and explores the idea of pain and euphoria. Appreciation of the physiology of labour and the role of pain helps us understand the function of pain in the labouring woman. Authors explore how this serves to enable a woman to capture attention, find safety, seek help, and maintain focus on self and baby. A discussion around the role of the mind in labour will lead to the consideration of pain perception and mindfulness. How a ‘mindful’ mind in labour that is focused and accepting in contrast with a ‘catastrophising’ mind in labour that is distracted and distraught will be discussed as well as the shifting between mindful and catastrophising that takes place. Finally, a debate on approaches to managing/controlling/acceptance of pain are presented for consideration on how we may apply these principles to practice.