The NCT has hailed today's publication of the Cochrane review of reviews as being a "significant breakthrough".

The report, entitled Pain management for women in labour: an overview of systematic reviews, provides evidence of the effectiveness of different approaches to working with pain during labour and pharmacological pain relief.

Co-author Mary Newburn (Head of Research and Information at NCT helped to shape the background literature and reporting, but wasn't directly involved in appraising the studies or analysing the evidence.

She said: "Women and healthcare practitioners [now] have comparative high-quality evidence of all the different approaches all in one place.

"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."

She added: "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."

However, the praise was countered with a warning when she explained how the review had 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).

She concluded: "Based on informal feedback from women and our own reviews of evidence, the NCT would especially welcome more research on relaxation and yoga interventions, aromatherapy, TENS, and different combinations of hetero- and self-hypnosis."

For more information on this report and other Cochrane reports visit

Posted by Penny Hosie 14.3.12