Pain in the first stage of labor: relationship with the patient's position.

This study was designed to evaluate the relationship between the parturient's position and her abdominal and lumbar (continuous and contraction) pain during the first stage of labor. A homogeneous group of 100 parturients was randomly assigned to alternately assume the horizontal or the vertical position for 15-min periods. Their pain was measured at 2-3, 4-5, 6-7, and 8-9 centimeters dilatation. To avoid "carry over" effect, these positions were preceded by a self-elected posture. Thus, the patient adopted (a) a self-elected position, (b) recumbent (or erect), (c) a self-elected position, (d) erect (or recumbent), and so on. Pain intensity was measured by the Argentine Pain Questionnaire's Present Pain Intensity and the Huskisson's visual analogue scale. Only the patients with at least one pain evaluation in both positions using both instruments were included in the study. The setting for the study was the obstetric department of a general hospital for people connected with public education (professors, teachers, or members of school administrative staffs). The analysis revealed that a majority of patients felt less abdominal and lumbar pain, either continuous or due to contractions, during recumbency. The effect was more remarkable when dilation exceeded 5 centimeters and less intense during the first half of the first stage of labor.