4.04 Evaluation of the Degree of Pain Experienced

a. What The Mother Says.

Is she requesting pain medication? Is she talking during the actual contraction?

b. Patient’s Response.

Comparison of the patient’s response to a given specific phase of labor to the expected response for that phase is considered.

The patient is usually talkative and able to walk about during the latent phase. Whereas, the patient may be nauseated, irritable, and uncooperative in the transition phase.

c. Facial Expression.

This usually gives the truest impression. Grimacing indicates increased pain.

d. Color of Skin.

If the patient’s skin is pale, she may be weak or tired. If she is perspiring, she may be working hard with each contraction.

e. Blood Pressure, Pulse, and Respirations.

The patient’s blood pressure is expected to elevate during the actual contraction, which is due to vasoconstriction. Her blood pressure should be taken at least fifteen seconds after contractions subsides. As anxiety and pain increase, the patient’s blood pressure, pulse, and respiration increase.

f. Posture.

The patient may become stiff and tense up. This is an indication that the patient is not tolerating well. Her legs and arms may be loose and relaxed. This indicates that the patient is effectively dilating with contractions.

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