Less Is More: The Recent History of Neuraxial Labor Analgesia

Bearing the Pain: A Historic Review Exploring the Impact of Science and Culture on Pain Management for Childbirth in the United States

Scientific advances over the past 150 years have influenced pain management practices during childbirth. Cultural attitudes about pain in childbirth have also affected these practices. The objective of this work is to examine the history of pain management in childbirth in the United States and explore the relationship between cultural attitudes and care practices. A historic review was chosen as the research method. Included were records that described pain management practices and records that explored the relationship between care practices and American cultural attitudes about pain in childbirth. The health science reference databases of CINAHL (EBSCO host), PubMed and the Cochrane Library were searched for English language articles. There were no limitations in years searched. Twenty-five primary records and 42 secondary records met inclusion criteria and were used in this work. Scientific developments as well as ever-changing cultural attitudes have greatly impacted pain management practices for childbirth in America. A highly complex and parallel, relationship exists between science and culture in regards to this history. To promote positive birth experiences for women, it is essential that obstetrical practices are congruent with cultural views regarding appropriate pain management in childbirth.

Analgesia for childbirth: modern insights into an age-old challenge and the quest for an ideal approach

SUMMARY It is widely recognized that childbirth may be the most painful experience in a woman’s lifetime and that women have a right to relief. There are many options, but the efficacy of only a few is supported by robust evidence. Many influences determine which method of pain relief is chosen, including social and cultural factors, availability, cost and personal preference. Due to human diversity and the differing perspectives of consumers, obstetric care providers and health administrators, there is no such thing as ‘an ideal approach’. In resource-rich societies, major advances in parturient safety and outcome flow from technique development and better monitoring. Greater awareness of the negative impact of untreated pain and of the relevance of genetic, cultural and social factors motivates research into better predictive models, novel therapies and optimization of existing methods.