title: Assessment of pain associated with childbirth: Women's perspectives, preferences and solutions.
abstract: OBJECTIVE
  to develop an understanding of women's experiences of pain associated with childbirth and the assessment of labour pain. This exploratory study, informed by modern pain science, sought to explore women's retrospective reports of their pain experience during labour and to ascertain what pain assessment strategies might be acceptable in maternity care or future research.
  
  
  METHODS
  a qualitative study was performed using phenomenology as the theoretical framework. Data were collected from semistructured telephone interviews. Thematic analysis of transcripts was performed.
  
  
  METHODS
  Melbourne, Australia.
  
  
  METHODS
  19 women - both primiparous and multiparous - who gave birth in a large maternity hospital, either in a midwife-led birth centre or with standard hospital birth suite care were interviewed in the month following labour and birth.
  
  
  RESULTS
  two themes were identified in post-birth interviews that related to pain assessment. The first theme is the acceptability of pain assessment and reflects the interview structure, drawing on responses from a set question that asked what pain assessment strategies would be acceptable. The second theme emerged from women's comments about measurement accuracy, including the limitations of using a scale with a static upper limit and the changing nature of labour pain.
  
  
  CONCLUSIONS
  a woman-centred approach demands pain assessment that matches each woman's preference for mode and timing and captures the multiple dimensions of pain. Women describe the need for an expanding scale to accommodate the progressive modifications of their conception of what is extreme pain.
  
  
  CONCLUSIONS
  whenever a series of pain ratings is required, researchers and health professionals need to find ways to adjust for the fluctuations in pain scale interpretation.
authors.affiliation: Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, 215 Franklin Street, Melbourne 3000, Australia; School Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia. Electronic address: jlc@latrobe.edu.au.
authors.forename: Lester E
authors.initials: LE
authors.lastname: Jones
authors.affiliation: Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, 215 Franklin Street, Melbourne 3000, Australia; School of Public Health and Human Biosciences, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia; School Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.
authors.forename: Laura Y
authors.initials: LY
authors.lastname: Whitburn
authors.affiliation: Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, 215 Franklin Street, Melbourne 3000, Australia; School Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Davey
authors.affiliation: Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, 215 Franklin Street, Melbourne 3000, Australia; School Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D048949:Labor Pain / Q000451:nursing / Q000523:psychology*; D008880:Midwifery; D010147:Pain Measurement; D018802:Patient-Centered Care; D011247:Pregnancy; D012189:Retrospective Studies; D014739:Victoria
keywords: Childbirth; Labour pain; Maternity care; Outcome measures; Pain assessment