Uterine Innervation

Pain early in the first stage of labor is largely generated from uterine contractions. Visceral sensory fibers from the uterus, cervix, and upper vagina traverse through the Frankenhäuser ganglion (lies just lateral to the cervix) ^ pelvic plexus ^ middle and superior internal iliac plexus ^ lumbar and lower thoracic sympathetic chains ^ enter the spinal cord through the white rami communicantes associated with the 11th and 12th thoracic and first lumbar nerves.

Pain relief during labor is a benefit-versus-risk tradeoff.

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