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The Nature and Management of Labor Pain
The Nature and Management of Labor Pain: core documents
Why The Nature and Management of Labor Pain was carried out How the labor pain systematic and narrative reviews were carried out Review results Ongoing work to use review results to educate professionals, women and the media and to improve practice Why The Nature and Management of Labor Pain was carried outFrom 2000 to 2002, Childbirth Connection (then known as Maternity Center Association) inaugurated its ongoing involvement with labor pain issues by carrying out The Nature and Management of Labor Pain. To address confusion and uncertainty about the nature of labor pain and the beneficial and harmful effects of specific labor pain relief methods, this project clarified current knowledge about these matters through a series of systematic reviews (when possible) and narrative reviews (when not). The objective of this work was to ensure that pregnant women have access to full and complete information about labor pain and pain relief well before labor and again during labor, and to inform health professionals, the media and other key groups about review results. Childbirth Connection also works to ensure that women have access to a choice of methods for labor pain relief and make informed decisions, according to their needs, preferences, and circumstances.How the labor pain systematic and narrative reviews were carried outTo address these objectives, Maternity Center Association (now known as Childbirth Connection) convened a multi-disciplinary Steering Committee of national leaders with expertise in anesthesiology, bioethics, childbirth education, consumer advocacy, epidemiology, journalism, labor support, midwifery, neonatology, nursing, obstetrics, pediatrics, physical therapy, and public health.The Steering Committee issued a statement of Values, Principles and Objectives to make these matters transparent (see box above). The Committee developed the scope of work for a series of planned reviews on specific methods for labor pain relief and related topics to help ensure that all important questions would be addressed and to limit duplication. The Committee specified that, where possible, the commissioned papers would use systematic review methodology. A subcommittee developed guidelines for authors (PDF) on systematic review methodology, and the Steering Committee invited leading researchers with topical expertise to prepare papers according to explicit scopes of work and the project guidelines. The full Committee met as an editorial board to review drafts of the papers and support authors in revising and strengthening the papers. Maternity Center Association established a partnership with the New York Academy of Medicine to hold a meeting to present and discuss the commissioned papers. The Nature and Management of Labor Pain: An Evidence-based Symposium was held at the Academy in May 2001. About 130 participants gathered to hear the papers, to hear commentary from two panels, and to discuss the issues at length. To ensure a balance of participants across all professions and organizations involved with labor, attendance was by invitation only. Following the meeting, authors finalized their papers and submitted them for publication. The peer-reviewed papers were published in a supplement to American Journal of Obstetrics and Gynecology (see box above). The issue includes an Executive Summary from the Steering Committee, which describes this work and the main results in detail and is available without charge on this site (see box above). Review resultsSeven systematic reviews and four narrative reviews were commissioned and published in the special issue. Please see the Steering Committee's Executive Summary (click in box above) for a detailed overview of the project process and methods and results of the reviews, which covered many related key questions and many outcomes.Systematic reviews were carried out and published on the following topics (with lead authors in parentheses):
Narrative reviews were carried out and published on the following topics (with lead authors in parentheses):
Ongoing work to use review results to educate professionals, women and the media and to improve practiceThis carefully coordinated evidence-based process clarified the state of the science for many related clinical questions, and Childbirth Connection and many others have been using results of the papers to strengthen policy, practice, research, and both professional and consumer education. Childbirth Connection has carried out media outreach to make key labor pain research results accessible to childbearing families and the general public.The papers have been widely cited, and results are being incorporated into health professional education programs. A number of derivative reports have been prepared, including two companion papers, an editorial and a consumer handout in American Family Physician Childbirth Connection's Listening to Mothers® surveys have further explored important labor pain questions from the perspective of mothers themselves, and are continuing to fill in gaps in knowledge in this area. For example, the surveys include data on rates of use of a wide range of pharmacologic and nonpharmacologic measures, ratings of the measures used, and knowledge about effects of epidural analgesia. Listening to Mothers II results, which will be reported in fall 2006, will enable a charting of pain relief trends and will provide data on additional pain relief topics. Related links, below, provide access to Childbirth Connection's in-depth labor pain resources developed from the systematic reviews and related labor pain work for consumers and journalists. Most recent page update: 9/29/2008
© 2010 Childbirth Connection. All rights reserved.
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families. |
News and Features : Health Professionals
New VBAC Guidlines
ACOG has just issued new Guidlines for VBAC. What changed? What continues? We've Moved!
On July 1, 2010, the Childbirth Connection office moved to 260 Madison Avenue, 8th Floor, New York, NY 10016. All other contact information is unchanged. "2020 Vision" and "Blueprint for Action" Reports Available
Rising Maternal Mortality
Help Transform Maternity Care!  Please join our efforts to make quality maternity care a top national priority. Your support will help make the transformation possible. View 2010 Supporter Roster 
Updated Maternity Care Statistics Available
US Cochrane Center (USCC)/Consumers United for Evidence-based Healthcare (CUE)
New Mothers Speak Out National Report Released The latest report in Childbirth Connection's Listening to Mothers series is now available. Get an eye-opening look at the reality of life as a mother of young children in the United States, based on national surveys conducted by Harris Interactive. Learn more, get the report Read the Wall Street Journal story and listen to the podcast Download Quick Facts (PDF) Why does the national U.S. c-section rate keep going up? Current research points to an optimal cesarean section rate of 5% to 10%, but 1 pregnant woman in 3 is giving birth by major surgery in the United States. Why the surge and is this safe? A new page - and a PDF handout for journalists, policy makers, students and others - answer these questions. Read more about the rising cesarean section rate New Content!
March/April 2009 evidence column is now available.
Features: National Quality Forum endorses consensus perinatal performance measures; systematic reviews on induction of labor, environmental tobacco smoke and fetal health, and HPV infection and cervical neoplasia Get the column Popular Pages
 Comfort in Labor, by Penny Simkin Penny Simkin, the internationally recognized leader in childbirth education and labor support, shares her wisdom with women, including comfort measures, effective positions, and tips for partners and doulas. Download Comfort in Labor (free PDF) 
Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should receive full information about all known and possible benefits and risks of participation, and she has the right to decide whether to participate, free from coercion and without negative consequences.
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