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Obstetrics Pain Management
Labor pain during childbirth is among the most severe forms of pain women face and it’s often underestimated. Neuraxial techniques remain the gold standard for effective analgesia, improving maternal comfort and safety. Evidence-based approaches help anesthetists deliver optimal outcomes and transform the childbirth experience.
Childbirth is a universal experience, yet no two deliveries are alike. Vaginal births often involve intermittent contraction pain, while instrumental deliveries add perineal discomfort from tissue stretching and possible trauma. Induced labor typically leads to stronger, more frequent contractions, perceived as more intense than spontaneous labor. Cesarean sections, accounting for about 21% of births², require surgical intervention and introduce postoperative incisional and visceral pain. Recognizing these variations and their broader implications makes labor pain management a critical challenge for anesthetists.
approx
0M
births occur globally every year.1
around
0M
worldwide births are vaginal deliveries.2
approx
0%
of women give birth by C-Section.2
Labor pain is an inevitable aspect of childbirth, yet its impact reaches far beyond delivery. Its intensity and character vary by birth type: spontaneous vaginal delivery typically involves intermittent contraction pain, while instrumental vaginal delivery adds perineal discomfort from tissue stretching and potential trauma. Cesarean section, although performed under anesthesia, introduces postoperative incisional and visceral pain, and induced labor often results in stronger, more frequent contractions perceived as more intense than spontaneous labor. Pain is not merely a physical sensation—it is shaped by biological, psychological, and social factors. According to the International Association for the Study of Pain (IASP), pain influences emotions, mood, daily activities, and relationships.3 When poorly managed, labor pain can lead to anxiety, negative birth experiences, and adverse postnatal effects⁴, with long-term consequences such as persistent pain and postpartum depression.
0%
of women wished they had recieved more analgesic support during labor.⁵
0%
of laboring women during labor felt severe
pain NRS > 8.⁵
0%
women in labor suffered severe pain for
too long.⁵
Prolonged labor pain increases the risk of postpartum depression by 154%⁶. Addressing pain effectively is essential not only for comfort but also for safeguarding postpartum well-being because, contrary to common belief, it's the severity of acute pain after childbirth, not type of delivery, that predicts persistent pain and postpartum depression.⁷
0%
increase of persistent pain risk due to severe acute pain.
0%
increase of postpartum depression risk when preceded by severe acute pain.
WHO recommendations
Intrapartum care for a positive childbirth experience - WHO recommendations: intrapartum care for a positive childbirth experience
link
WFSA Labour Analgesia Declaration
Labour Analgesia Declaration – WFSA
link
ASA Practice Guidelines for Obstetric Anesthesia
An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology Anesthesiology
link
ASA Statement on Neuraxial Analgesia or Anesthesia in Obstetrics
Standards and Practice Parameters Statement on Neuraxial Anesthesia in Obstetrics
link
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1. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. 4p. WHO recommendations: intrapartum care for a positive childbirth experience
2. Angolile CM, Max BL, Mushemba J, Mashauri HL. Global increased cesarean section rates and public health implications: A call to action. Health Sci Rep. 2023 May 18;6(5):e1274. Global increased cesarean section rates and public health implications: A call to action - PMC
3. Pain – National Institute of Neurological Disorders and Stroke. Available from: https://www.ninds.nih.gov/health-information/disorders/pain [Last accessed on 2025 July 16] Pain | National Institute of Neurological Disorders and Stroke
4. Farnham T. Reviewing pain management options for patients in active labor. Nursing2020. 2020 Jun;50(6):34-41 Nursing2025
5. Tascón Padrón L, Emrich NLA, Strizek B, Schleußner E, Dreiling J, Komann M, Schuster M, Werdehausen R, Meissner W, Jiménez Cruz J. Quality of analgesic care in labor: A cross-sectional study of the first national register-based benchmarking system. Int J Gynaecol Obstet. 2024 Sep;166(3):1077-1085. Quality of analgesic care in labor: A cross‐sectional study of the first national register‐based benchmarking system - Tascón Padrón - 2024 - International Journal of Gynecology & Obstetrics - Wiley Online Library
6. Zeng J, Liao Z, Lin A, Zou Y, Chen Y, Liu Z, Zhou Z. Poor control of pain increases the risk of depression: a cross-sectional study. Front Psychiatry. 2025 Jan 7;15:1514094. Poor control of pain increases the risk of depression: a cross-sectional study - PMC
7. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008; 140(1):87-94. Severity of Acute Pain After Childbirth, but not Type of Delivery, Predicts Persistent Pain and Postpartum Depression - PMC
8. Liu ZH, He ST, Deng CM, Ding T, Xu MJ, Wang L, Li XY, Wang DX. Neuraxial labour analgesia is associated with a reduced risk of maternal depression at 2 years after childbirth: A multicentre, prospective, longitudinal study. Eur J Anaesthesiol. 2019 Oct;36(10):745-754. Neuraxial labour analgesia is associated with a reduced risk of maternal depression at 2 years after childbirth: A multicentre, prospective, longitudinal study - PMC
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