ScienceDaily (Apr. 15, 2008) — Childbirth is painful, yet scientists are still somewhat in the dark about what actually causes the pain. A new doctoral thesis from the Swedish medical university Karolinska Institutet now shows where this pain comes from and opens the way to the development of improved methods of pain relief.

In her thesis, obstetrician Berith Karlsson Tingåker has examined the source of pain during childbirth and how uterine sensitivity to pain changes during pregnancy. Her results show that labour pains mainly derive from the cervix, where the number of pain-related nerve fibres and receptors is much greater than in the uterus at full-term pregnancy.

Her thesis also shows that uterine pain sensitivity differs markedly between pregnant and non-pregnant women. In the latter, the entire uterus is pain-sensitive, while in the former, the pain-sensitive nerve fibres disappear almost completely from the main body of the uterus, but remain in the cervix.

Spinal anaesthesia is currently the most effective way of providing pain relief. However, it is a resource-demanding method and has other drawbacks that limit its practicability.

“The results create new opportunities for developing simpler and more effective methods of pain relief, with the focus on the cervix,” says Berith Karlsson Tingåker. “Women in Sweden and around the world, many of whom have no access to pain relief, are literally crying out for them.”

Thesis: Changes in human uterine innervation in term pregnancy and labor. Occurrence and roles of neurotrophins and TRPV1, Berith Karlsson Tingåker, The Department of Woman and Child Health, Karolinska Institutet.

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