Childbirth Experience Determines Memory of Pain
It is already known that caregivers’ attitude and behavior is important in determining whether a woman has a satisfying experience of childbirth. But our knowledge about memory of labor pain is still limited. Is satisfaction with labor linked to memories of the pain?
Professor Ulla Waldenstrom and colleagues at the Karolinska Institute in Sweden explain that the memory of labor pain usually reduces over time, but for some women it increases. The team set out to investigate the memory of labor pain after two months, one year, and five years, and whether it is linked to the pain relief used and the woman’s feelings about her experience.
They examined figures on 1,383 women who gave birth in Swedish hospitals in 1999. Five years on, the women completed questionnaires on their memories of the birth. Pain was rated on a seven-point rating scale (1 = no pain at all, to 7 = worst imaginable pain).
After five years, nearly half (49 percent) of the women remembered birth as less painful than when they rated it two months after the birth. Just over a third (35 percent) rated it the same, but 16 percent rated it as more painful.
Results appear in BJOG: An International Journal of Obstetrics and Gynaecology.
The authors say that evaluation of childbirth was indeed associated with recollection of labor pain after two months. Women who reported labor as a positive experience after two months also had the lowest pain scores after one year and five years. Women who rated their childbirth as negative or very negative were more likely to rate their pain the same, but women who had epidurals remembered pain as more intense. This may be because the pain was more intense in the first place, say the experts, or it may be that the women primarily remembered the pain just before the epidural was given.
They write, “There was significant individual variation in recollection of labor pain. In the small group of women who are dissatisfied with childbirth, memory of pain seems to play an important role many years after the event.” The experts say this challenges the view that labor pain has little influence on subsequent satisfaction with childbirth. Labor pain and long-term memory of pain involve different memory systems, they suggest.
Professor Waldenstrom concluded, “Around 60 percent of the women reported positive experiences and less than ten percent had negative experiences. A commonly-held view is that women forget the intensity of labor pain. The present study, which measured women’s memory of labor pain up to five years after the birth, provides evidence that in modern obstetric care, this is true for about 50 percent of women.