women's pain

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From Journal of Midwifery & Women's Health

Pain in Women's Health: A Multi-Faceted Approach Toward Understanding

Posted 11/22/2004 F. McCool, CNM, PhD; Tara , SNM, BA; Christy Aberg, SNM, BA

Abstract and Introduction

Abstract

Pain has always been a part of women's health experiences, inherent to such physiologic processes as menstrual cramping, labor contractions, and uniquely female illnesses, such as cervical or ovarian cancer. However, the understanding of pain -- its nature, its purpose, and its sometimes debatable need for removal -- remains elusive. Pain's origins are in the physical realm, but it is manifested through an array of psychological, social, and cultural factors. The concept of pain is explored using an evolutionary approach to understanding the mechanisms associated with the physiologic, psychological, developmental, and sociocultural aspects of this phenomenon. The relevance of this exploratory look at pain as it relates to offering health care to women is discussed. The manner in which pain affects individuals and the methods with which it can be treated are critical elements in the provision of quality health care.

Introduction

"The human condition is such that pain and effort are not just symptoms which can be removed without changing life itself; they are the modes in which life itself, together with the necessity to which it is bound, makes itself felt. For mortals, the 'easy life of the gods' would be a lifeless life."

Hannah Arendt, 1958[1]

Philosopher Hannah Arendt believed that pain was an essential part of the human condition, one which would become "lifeless" should the feeling of pain be removed. Indeed, for centuries philosophers, healers, and poets have spoken of the importance of pain to the process of being human. In the minds of many, pain is a necessary part of life, and is not easily removed, nor should it be.

Enter the 21st century. Pain, and determining ways to control it, is on the minds of Americans. Many persons today are unwilling to accept pain as a natural condition of life. From infancy through adulthood, pain is viewed as a negative condition that should be avoided or overcome at all costs. It is estimated that $100 billion is spent annually on pain care in the United States.[2] Over $4 billion is spent annually on over-the-counter pain medications for headache.[3] In 1999, it was estimated that over 48 million Americans experienced chronic pain.[2] There are approximately 70 million emergency room visits annually, and $65 billion lost in productivity each year due to pain.[2]

The concept of pain encompasses multiple dimensions. While pain's stimulus is in the physical realm, the experience of pain is affected by an array of social, cultural, and psychological factors that make understanding and treating pain a difficult task. Pain management is an essential part of clinical practice, one that is best served by exploring the concept of pain, the manner in which it affects individuals, and methods for abrogating it or assisting the individual in coping with its effects.

This article uses an evolutionary approach to understanding the physiologic, psychological, developmental, and sociocultural aspects of pain; in particular, as they affect women, especially with regard to conditions that are unique to or prevalent in women.

Section 1 of 10

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F. McCool, CNM, PhD, FACNM, received his midwifery education at the Medical University of South Carolina in ton, SC, and his doctoral education at Penn State University in State College, PA.Tara , SNM, BA, received her BA in English and Theatre at the University of Delaware in Newark, DE. She has since received her certification in Massage Therapy at the Arizona School of Integrative Studies in Camp Verde, AZ, and has studied Ayurvedic Medicine in Kerala, India.Christy Aberg, SNM, BA, received her BA in psychology at Hamilton College in Clinton, NY. She has worked as a doula and maternal/infant health educator in Providence, RI, as a member of AmeriCorps.

On the basis of the belief that all human beings share the same divine nature, we have a very strong ground, a very powerful reason, to believe that it is possible for each of us to develop a genuine sense of equanimity toward all beings.-His Holiness the Dalai Lama, "The Good Heart"Copyright Wisdom Publications 2001. Reprinted from "Daily Wisdom: 365 Buddhist Inspirations," edited by Josh Bartok, with permission of Wisdom Publications, 199 Elm St., Somerville MA 02144 U.S.A, www.wisdompubs.org. Peggy