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It's not just labour that hurts: a service evaluation study of acute pain service involvement in a tertiary referral obstetric unit

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It’s not just labour that hurts: A service evaluation of acute pain service involvement in a tertiary referral obstetric unit

SD Balakrishnan, A Banks, A Pillai
City Hospital, Nottingham University Hospitals NHS Trust 


•  Effective pain relief is a vital component of good quality care. It can increase patient satisfaction and reduce complications and morbidity.1

•  Pregnant women can have acute pain due to conditions related to or exacerbated by pregnancy, or due to incidental pathologies occurring during pregnancy.

•  Healthcare professionals can feel anxious about prescribing analgesics in pregnancy due to concerns about causing harm to the developing fetus.

•  This can lead to inadequate analgesia in pregnant women and maternal dissatisfaction.

•  An Acute Pain Service (APS) can provide support and specialist pain advice.

•  This study aimed to establish the types of non-labour pain experienced in pregnancy and the puerperium and to evaluate the services provided by an APS in a large tertiary referral obstetric unit.



•  A retrospective service evaluation of all obstetric patients who required APS input outside of labour.

•  Cases were identified from the period May 2010 and September 2014

•  Data were collected from the APS records of the identified cases. 



• This study demonstrates that non-labour pain can be a significant problem in pregnancy.

• It highlights the need for appropriate APS input as good pain management increases patient satisfaction.1

• The APS offers a holistic approach to pain management and uses a wide range of pharmacological and non pharmacological modalities.

• Non-pharmacological modalities are popular in pregnancy as women prefer to avoid medication for fear of harming their unborn child.

• Posters have been placed on maternity wards to raise awareness of the role of the APS, encourage appropriate referrals and to describe the services that can be offered. 


1. Association of Anaesthetists of Great Britain and Ireland, The Pain Society. Provision of Pain Services. London: AAGBI/Pain Society, 1997. www.aagbi.org/ sites/default/files/painservices97.pdf 

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