Changing the way we think about pain

Pain and fear are high on the list of reasons that women give for seeking hospital admission when they are in labour (Cheyne et al 2007, Barnett et al 2008, Carlsson et al 2009, Carlsson 2016). The timing of admission to hospital is important because women experiencing an uncomplicated pregnancy are at increased risk of obstetric intervention if they are admitted to hospital during early labour (Bailit et al 2005, Lundgren et al 2013, Neal et al 2014). This knowledge causes many women, who might have benefited from professional psychological support, to be sent home and left to manage this period of labour alone (Barnett et al 2008, Eri et al 2015). More work is needed to understand how women can be effectively supported in managing their pain at this time and safely await active labour before coming to hospital (Eri et al 2015, Kobayashi et al 2017). This paper is presented as one of two papers aimed at prompting our thinking and understanding around pain perception in labour. It provides a summary of our current understanding about pain, and highlights pain catastrophising and how it might affect childbirth. We discuss the importance of effective psychological support for women, and how hypnosis may be one intervention to support women in early labour and encourage their timely admission to hospital