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Introduction
Discomfort or even pain are, unfortunately, not uncommon features of pregnancy.
The causes are quite often directly related to the pregnancy. These may include an over-exuberant fetus, pressure effects from the fetal head or limbs, and over-distension of the abdomen because of a large fluid volume, a big baby or both. There are several others, as we shall see shortly.

Other causes of pain in pregnancy are only indirectly related or even incidental.
The attending doctor needs to be able to discriminate between the miscellaneous pregnancy-related discomforts and pathological causes of pain, which may require specific remedial action. It is after this that all forms converge under a common denominator, that of pain, hence requiring relief.

Modes of pain relief during the course of pregnancy are limited and in many cases not as effective as the expectant mother - or her doctor - would like. However, establishing the cause of her discomfort or pain and confirming the absence of any underlying serious illness does go a long way in enabling the mother­-to-be to cope.

Sometimes, the pain is so severe as to prompt induction of labour. This is uncommon. This decision should never be taken lightly, not least because it has a tendency of assuming a slippery-slope phenomenon. Induction of labour, especially if remote from term, can be a protracted affair and psycho­logically and physically traumatic. The success of the procedure is also far from being a foregone conclusion and may very well lead towards a caesarean section.
The various aspects of pain in pregnancy are discussed here.

32. Pain in pregnancy

By Dr Joe Kabyemela, MD

Physiological pain Ligament pain Pathological pain Braxton-Hicks Uterine torsion Symphysis pubis Backache