Remembrance of labor pain: how valid are retrospective pain measurements?

Abstract

Recently, several authors have questioned the reliability and validity of relying on retrospective assessment of labor pain. Many studies designed to determine the relationships between psychosocial and demographic factors and pain intensity during labor have relied on such measurements. The purpose of this prospective study was to determine if primiparas and multiparas can accurately remember the pain of labor. Fifty primiparas and 88 multiparas participated in the study. Prospective assessment of in-labor pain was performed using a Visual Analogue Scale (VAS) in 3 phases of labor. Retrospective assessment of labor pain was performed 2 days post partum using the VAS. Results showed that there were significant differences between the amount of actual pain reported and the amount of pain and discomfort remembered by both primiparas and multiparas. The mean rating for remembered discomfort was higher than for remembered pain. The subjects tended to deflate the intensity of their labor pain. The results suggest that previous studies that have relied on retrospective assessments of labor pain may be invalid.

Psychophysics in the field: Perception and memory for labor pain

“…Virtually all extant studies have relied on either a single retrospective rating of the entire experience of labor or on a few one-time ratings from different phases of labor (Bonnel & Boureau, 1985;Cogan, Henneborn, & Klopfer, 1980;Melzack, Kinch, Dobkin, Lebrun, & Taenzer, 1984;Melzack, Taenzer, Feldman, & Kinch, 1981;Nettelbladt, Fagerstrom, & Uddenberg, 1976;Niven & Gijsbers, 1984;Norvell, Gaston-Johansson, & Fridh, 1987;Pesce, 1987;Rofe & Algom, 1985). Yet it is highly questionable whether a single estimate or a handful of sporadic judgments can capture the full spectrum of sensations involved in so rich, intricate, and multifarious an experience as labor.…”

“…A recent study by Norvell et al (1987) may serve to illustrate some of the problems plaguing earlier research. Assessment of a given phase of labor was obtained prospectively during labor, and again, retrospectively, 2 days postpartum.…”

Autobiographical Memory and the Validity of Retrospective Reports

“…Labor is thoughtto be quite painful, yet most mothers are unlikely to dwell on the intensityof such pain after the child is born. Norvell, Gaston-Johansson, and Fridh (1987) found that pain ratings on visual analogue scales made during three phases of labor revealed considerably more intense pain than did retrospective ratings made2 days postpartum. It maybe that when pain intensity is low-for example, several days after the birth of a childmemory for the original experience of pain is underestimated; but that when existing pain intensity is high or can be high, as in a chronic pain patient, memory for the original pain experience is augmented (E. Eich, Reeves, Jaeger, & Graff-Radford, 1985).…”

“…Painful experiences are certainly affectively charged events, and memories about them maybeorganized aroundtheiraffective qualities. The role of moods and emotions in the accuracy of judgments aboutand recallof painful experiences has not been studieddirectly (although for an exception see E. Eich, Rachman, & Lopatka, 1990) despite the fact that many researchers (e.g., E. Eich et al, 1985;Hunter et al, 1979;Kent, 1985Kent, , 1989Norvell et al, 1987;Roche & Gijsbers, 1986) have suggested it as the key variable mediating the accuracy of pain recall.…”

Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience

“…The VAS is a validated and commonly used instrument for assessing pain and has been used in previous studies of acupuncture for labour pain [4-6, 8, 10, 29] and pain recollection [30,31].…”