Little evidence that one type of pain relief for labour is better than another, finds Cochrane review

BMJ 2012; 344 doi: (Published 14 March 2012) Cite this as: BMJ 2012;344:e2074
  1. Jacqui Wise
  1. 1London

A Cochrane review has concluded that many non-drug methods of pain relief in labour, such as TENS and aromatherapy, are poorly researched and there is not enough evidence to say whether they are any more effective than placebo.

The “review of reviews” found more evidence to support the efficacy of pharmacological methods, but these do have more adverse effects. Considerable evidence exists that epidural analgesia, for example, does provide effective pain relief but it also increases the risk of forceps or ventouse being used during the birth. Epidurals also increase the risk of low blood pressure among women, motor blockade (which hinders leg movement), fever, and urine retention.

The overview included 18 systematic reviews of different interventions used to reduce pain in labour, 15 of them Cochrane reviews. A total of 312 trials were included.

Most of the evidence on non-drug interventions was based on just one or two studies and the findings are not definitive. The authors conclude, however, that there is some evidence to suggest …

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