Monday, February 8, 2010

Pain Medication Preference Scale

by Penny Simkin, taken from "The Birth Partner"

Explore how you feel, either as a mother or as a birth partner.

Every number on the scale is a potential realistic feeling except the extremes (+10 and -10), which are included as reference to other numbers on the scale.
Note: avoiding pain meds requires more preparation than using them.

+10    Desire to feel nothing; desire for anesthesia before labor begins (this is an impossible extreme).

+9     Fear of Pain; mother believes she cannot cope; dependence on staff for total pain relief.

+7     Definite desire for anesthesia as soon as the doctor will allow it, or before labor becomes painful.

+5     Desire for epidural anesthesia in active labor (at 4-5 cms dilation). Willingness to cope until then, perhaps with narcotic medications.

+3     Preference for using medication, but as little as possible, with some sensation. Desire to use self-help comfort measures. Natural childbirth is not a goal.

0      No opinion or preference. This attitude is rare among pregnant women, though not among birth partners or doulas.

-3     Would like to avoid pain medications unless coping becomes difficult. Would not feel disappointed or guilty if she used medications.

-5      Strong preference to avoid pain medications, to avoid side effects on the baby or the labor. Will accept medications for a long or difficult labor.

-7     Very strong desire for natural childbirth, for a sense of personal gratification as well as to benefit the baby and the progress of labor. Will be disappointed if she needs to use medication.

-9     Desire that birth partner and staff deny mother pain medication, even if she requests it.

-10   Desire that the mother forego all medications, even for cesarean delivery (impossible).


  1. Hmmmm... I think I'm a -8. But who knows. Even menstrual cramps send me flying for Midol.

  2. I'd like to think I'd be a -5, and remain open to the possibility of help of medications when they would help me sleep (or for severe pain.. I've never been in labor so I don't know how I'll handle it yet!) without being disappointed later, but who knows.

    I've heard so many accounts of the woman wanting so much to avoid medications, giving in because the labor was longer or harder than they thought, but then ended up with the whole slew of interventions that can potentially come after (the snowball effect) and are deeply disappointed!

    So maybe I'm a -6

  3. True emotional pain is not relieved with an analgesic, but the pains are usually physical and emotional not so good analgesic and hydrocodone may be the best solution for pain.


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