Examining the nexus of labour pain and culture using an applied social science framework

Resumen

Birthing women can convey a cultural response to pain. The greater the cultural distance between a woman and her midwife, the greater the chance of misinterpretation of her labour experience. This paper examines childbirth beliefs, influences and practices, which contribute to cross-cultural understandings of pain. A literature search was conducted in April 2013. Studies were included if they had pain as the primary outcome and examined non-elicited pain language from the maternal perspective. Twelve articles were included. The language findings were reported in a companion paper. The present paper reported the cultural findings using an applied social science framework to reflect upon the nexus of pain and culture within pain communication and the development of culturally sensitive practice. The studies depicted shared childbirth beliefs and practices across African, Asian, European, North American and South American cultures, which in part is attributed to common physiological factors of childbirth. Childbirth may be impacted upon by ‘internal’ factors: pain reactions and attitudes, religion and spirituality, pain definition and meaning, anxiety, pain acceptance and tolerance, conceptualisation of motherhood, psychology, and societal beliefs; external factors may include the environment (physical setting or context of childbirth) and the model of care. The interpretation of these beliefs may be influenced by the midwife’s development of their cultural competence.Viewing cultural patterns provides a cultural lens for midwives across care models (e.g. technocratic, humanistic, and holistic) to better understand women’s experiences of pain, to reflect upon cross-cultural interpretation of pain and to develop cross-cultural competence.