Drugs 'better for labour pain'

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14 March 2012

Taking drugs to relieve pain in labour works better than alternatives such as massage, Tens machines and hypnosis, new research shows.

Painkillers such as an epidural, as well as gas and air, are more effective than softer approaches but do have more side-effects, according to the review of 310 studies.

Experts found that epidural, combined spinal epidural (CSE) and inhaled gas and air effectively managed pain in labour.

CSEs relieved pain more quickly than traditional or low dose epidurals while epidurals resulted in higher rates of assisted delivery, such as forceps or ventouse, and women were more likely to suffer problems such as high blood pressure and fever.

Women taking gas and air were more likely to experience vomiting, nausea and dizziness, the study also found. Meanwhile, being immersed in water, relaxation techniques, acupuncture, massage and non-opioid drugs such as sedatives were described as interventions that "may work" with fewer adverse effects.Both relaxation and acupuncture decreased the use of forceps and ventouse in delivery, with acupuncture also decreasing the number of caesarean sections.

However the team found there was "insufficient evidence" to make judgments on whether treatments such as hypnosis, sterile water injections, aromatherapy, Tens machines or opioids such as pethidine were more effective than dummy treatments for managing pain in labour.

In comparison with other opioids, more women receiving pethidine experienced side-effects including drowsiness and nausea, according to the research from the Cochrane Collaboration.

The experts, from universities including Liverpool, Warwick and Manchester, said: "Overall, women should feel free to choose whatever pain management they feel would help them most during labour.

"Women who choose non-drug pain management should feel free, if needed, to move on to a drug intervention. During pregnancy, women should be told about the benefits and potential adverse effects on themselves and their babies of the different methods of pain control."

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