Wednesday, August 16, 2006

What is "natural" pain relief?

We started talking about this in the previous thread, but I'd like to explore it in more detail.

DEMs claim, and many of their patients agree, that they know natural methods to reduce the pain of labor. I have several questions, though.

In general, the success of pain relief is measured by its ability to reduce pain. While some relief is undoubtedly better than none, we would not judge a pain reliever as particularly effective if it only reduced the pain from excruciating to bearable but agonizing. So my first question is: how effective is natural pain relief?

Second, we all know about the placebo effect. That is the name for the phenomenon that occurs when someone is told they are getting a medication or using a technique that will make them feel better. Up to 30% of the people who are taking the control medication (usually a sugar pill) will claim to feel better. Therefore, simply relying on patient reports is not enough when evaluating a technique. Is there any evidence besides patient reports to show that these techniques work? Specifically, are their any trials that compare natural pain relief to pharmacologic methods?

Third, if something really works, it will work whether the patient expects it to or not. If natural pain relief really works, it will work for people who are not committed to it as well as for people who are. What evidence to we have that natural pain relief techniques provide sufficient pain relief for women who have no commitment to natural childbirth?

Finally, if it turns out (as I suspect it will) that natural pain relief reduces pain slightly, works best in women who are committed to natural childbirth, and provides very little or no relief to women who are not committed to natural childbirth, is it really a method of pain relief, or simply a method to bolster pre-existing willpower to avoid pain medication of any kind?

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