Stephanie Power

The elicited verbal pain language of childbirth: a closer look at pain assessment through a critical and interpretive review of the literature

OBJECTIVE: To provide a critical and interpretive review of the literature to investigate examples of pain assessment tools used in a childbirth context. Through these examples of pain assessment, the concept of elicited verbal pain language is introduced and explored. METHODS: Electronic search strategies were used to identify primary research regarding maternal reports of pain (during labor, postpartum and retrospectively), which were captured by standardized pain assessment tools. FINDINGS: The review revealed the physiological (the sensory and affective dimensions of pain, the intensity of pain, and the influence of parity on pain perception), psychological (the influence of maternal attitude, mood, and memory on pain perception), and ethnocultural (the impact of the ethnocultural context on pain perception) components of the pain experience. The strengths and limitations of pain assessment tools are highlighted. There were similarities in the reviewed studies’ approaches to pain assessment despite the cross-cultural representation of birth. Possible implications for cross-cultural pain assessment and communication are outlined. CONCLUSION: The question remains regarding the appropriateness of implementing standardized pain assessment tools across birth context. An ongoing critique of pain assessment may inform the provision of better care overall for birthing women in multicultural societies.

A Critical Analysis of Women's Descriptions of Labor Pain Based on the McGill Pain Questionnaire

OBJECTIVE: The purpose of this article was to examine childbirth (labor) pain language through an analysis of the McGill Pain Questionnaire (MPQ) descriptors. METHOD: Language was extracted from 6 studies which used MPQ descriptors (and originally formed part of a larger interpretive review of pain assessment). MPQ descriptors are considered rich language data because they provide insight into the different qualities and dimensions of pain. An applied linguistic approach, which examines language in its real world context (in this instance, childbirth and midwifery) was used to analyze maternal language. FINDINGS: The MPQ descriptors conveyed sensory, affective, evaluative, and miscellaneous dimensions of the labor pain experience. Words were classified according to the semantic category of the descriptors (the associated meanings of pain words), parity, stage of labor, and the location of pain. Generalizations cannot be made from this small sample of maternal language; however, this analysis provides an introduction to maternal MPQ descriptors and gives insight into a possible association between maternal MPQ descriptors and words which may be used to represent other female pain events. CONCLUSION: The descriptors analyzed in this article revealed a rather homogeneous language; yet, they provided insight into the qualities and intensity of labor pain across women of different parity. Pain can be quantified in a numeric-verbal language, but the use of a pain measurement tool alone may lead to assumptions or underestimations of the individual nature of a woman’s labor, which may impact on her pain management. An acknowledgment of a woman’s labor as intimate and emotive is also needed, which is captured in the spontaneous language of her own account of labor.