NCT response to Pain management for women in labour: an overview of systematic reviews

Released on: 14 March 2012

Today the Cochrane review of reviews: Pain management for women in labour: an overview of systematic reviews was published. Mary Newburn is a co-author of the review and helped to shape the background literature and reporting. She was not directly involved in appraising the studies, extracting the data or analysis the evidence

Mary Newburn, Head of Research and Information at NCT, the UK's largest charity for parents, said: 

“‘NCT welcomes the new Cochrane review of reviews providing evidence of the effectiveness of different approaches to working with pain during labour and pharmacological pain relief. It is a significant breakthrough for women and healthcare practitioners to have comparative high-quality evidence of all the different approaches all in one place. This makes it a realistic option to compare the known strengths and weaknesses of all the different approaches.

“The review finds that ‘epidural, combined spinal epidural (CSE) and inhaled analgesia effectively manage pain in labour, but may give rise to adverse effects, including the need for an assisted delivery (with forceps or ventouse) and caesarean birth for foetal distress.

“Some methods of working with pain show particular promise. For example, relaxation was associated with fewer assisted vaginal births and acupuncture was associated with fewer assisted vaginal births and caesarean sections.  Immersion in water and relaxation also gave better satisfaction with childbirth.

“Maternity services should review what they provide as a standard part of their offer. On the basis of the review we would expect to see trusts and boards extending the range of choice and providing more antenatal relaxation courses and more access to acupuncture. 

“More than anything the review highlights the urgent need for more research. The review found there is insufficient evidence to make judgements on the effectiveness a number of methods (hypnosis, biofeedback, sterile water injection, aromatherapy, TENS, or parenteral opioids). Based on informal feedback from women and our own reviews of evidence, NCT would especially welcome more research on relaxation and yoga interventions,(1,2) aromatherapy, TENS, and different combinations of hetero- and self-hypnosis.(3)”

1. Campbell V. Yoga in pregnancy: a glance at the evidence. New Digest 2010;(51):23.

2. Campbell V. Yoga in pregnancy: relax, stretch and breathe: how yoga helps in pregnancy and labour. New Digest 2010;(49):6-7.

3. Semple A, Newburn M. Research overview: self-hypnosis for labour and birth. Perspective 2011;(13):16-20.