9/15/88 Field Note
You asked me to tell you about my experience with pain in childbirth. It's been quite a few years since I've had a baby. The funny thing about pain, whatever its source, is that once it's over, you kind of bury it deep in your subconscious somewhere. You can say that it was awful or not so bad, but this expression is filtered through a haze. You can't really feel it anywhere, you just have images of what you think it was like. Do you know what I mean?
Childbirth is weird. You kind of dread it because you hear so much about the pain of labor, on the other hand you look forward to it because you're tired of carrying the child and anxious to see it. The pain is seen as the only way of getting there so you know you have to go through it. You just hope that it won't be too bad. Or that they will give you something if it is. The pain is expected, you think about it, dread it, prepare for it by going to classes and learning how to control and tolerate it. In the beginning it's not too bad, toward the end though, it kind of overwhelms you. The force just kind of takes you over. But you do have moments of rest in between. And you know it is going to end, as soon as that baby comes out. And they can give you something to make it hurt less. I was lucky. I had short labors. So I didn't need any kind of medication. I just used my breathing and relaxing exercises. But I can see that if it goes on for hours and hours how you would get tired and need something.
10/10/89 Code Note
Analysis pertains to fieldnote Code #45, p.2, dated 9/15/88. PAIN, PAIN MANAGEMENT CONDITIONS, ACTION/INTERACTION STRATEGIES, CONSEQUENCES OR MANAGING THE PAIN OF CHILDBIRTH
We are talking here about a particular type of pain event-that associated with childbirth. This association gives the pain experience its specific properties or location along the dimensional continua. The pain of childbirth is expected (degree of expectancy), can be controlled (degree of controllability) grows more intense as the labor progresses (degree of intensity also denotes that there is phasing), has a known beginning, onset of labor, and an end, delivery of the child (course of trajectory), and it is intermittent with periods of no pain in between (degree of continuity). Oddly enough, the pain of childbirth has another quality or characteristic that is quite strange and difficult to express. Pain is* part of a labor process, labor of course serving an end-the end of pregnancy, the delivery of the awaited child. Hmm. How do I describe this property? The pain itself is not purposeful, but associated with a purposeful activity-labor. (**** I'll note this though I'm not yet sure what to do with this. It doesn't necessarily mean acceptance (though it might to some people), or tolerance, but perhaps it gives the pain a certain degree of predictability? This still doesn't quite capture this phenomenon.)
These specific properties of childbirth pain create the context in which the management of that pain takes place from the women's perspective.
From this fieldnote I can come up with the following potential relationships. Under conditions, where the pain (childbirth) is known beforehand, thus one can prepare; when it is intermittent rather than continuous; when its intensity varies over the course from mild at the beginning to more intense later; when labor is fairly short or at least follows a predictable course; and there are known techniques for controlling its intensity and these can be learned or negotiated for. Then, one can take action to control the intensity of the pain during labor through pain management techniques such as the use of relaxation and breathing techniques, pain medication, or anesthesia (caudal, pericervical). The consequences or outcomes of the use of these management techniques may not be absolute control but control of sufficient degree to get one through the labor.
One may enter labor with some predefined sense of what management techniques one is likely to use, such as breathing and relaxation techniques, however if the pain management context changes due to contingency such as labor becoming prolonged due to complications, then one may have to alter that predefined plan of management and use supplements or alternatives to those original techniques.
Other potential categories, properties to come out of this fieldnote to be explored in further memos are:
pain consciousness or memory-this seems acute at first but dulls with time. Phases of pain trajectory-this bears examining. Predictability of the pain and how this acts as a condition for management.
This fieldnote suggests but does not address: What about the timing and amount of medication, anesthesia? What are their effects, potential risks?