November 1, 2001-Vol33n9: Study to focus on labor pain

Study to focus on labor pain

By PATRICIA DONOVAN
Contributing Editor

Researchers at UB and Ohio University are using the Internet to collect data from thousands of women from all over the world about their experience of pain during labor in order to understand how best to ease the pain of childbirth.

This is one of the first large-scale Internet-based survey research studies to be undertaken and is expected to yield a large foundational population sample for the study of labor pain.

"Most studies that assess pain-management methods have used very small sample sizes and inconsistent approaches, which makes it nearly impossible to draw solid conclusions or extend their results to the larger population," says investigator William Schmidt, UB assistant professor of psychology.

Adds collaborator Christopher France, professor of health psychology at Ohio University: "The beauty of this procedure is that there are no limits on how many people can participate."

Janis France, assistant research professor at Ohio University, who also is collaborating on the project, says she used distraction, imaging, pain medications and a combination of other techniques during the labor and delivery of her own two children. "I would have been interested to know before adopting an approach to pain relief how these things had worked for other women."

The project is exploiting this rich source of primary data through an online survey that asks recent mothers and mothers-to-be about various pain-control techniques they used or expect to use during labor and delivery. Such techniques may include breathing exercises, epidurals and other pain-relieving medications, distraction techniques, meditation and a host of other commonly used methods.

Participants also are asked about their anxiety over labor pain and how much pain they actually experienced or expect to experience during childbirth.

The researchers will use email to follow up with pregnant volunteers to learn how their expectations compared to their actual experiences, what pain-control methods they actually used during labor, and whether these methods were effective.

Demographic information collected via the survey, such as age, race, income and educational level, will make new information available about the childbirth experiences of a diverse group of women.

Schmidt points out that human perception systems, the principal subject of his research, appear to affect the way we experience pain, and pose interesting philosophical problems regarding the relationship between mind and body.

"There is a large psychological component to the pain experience in general and that certainly is true during labor," he says.

"By contrasting the most positive childbirth experiences on a variety of measures, we hope to get insight into procedures and settings that can be used to systematically minimize the experience of labor pain in women from a variety of demographic backgrounds."

This study broaches issues related to survey methodology as well. The Internet is a vast, untapped source of information, but Schmidt says researchers approach its use as a survey tool with apprehension.

"It's not used frequently," he says, "because it's difficult to determine exactly who is in an Internet sample. Ordinarily, that makes the Internet inappropriate for collecting data for any study whose findings will be applied to the larger population."

In this case, however, he says one of the strengths of using the Internet is that information can be collected from a large number of targeted subjects and then compared to the census and other demographic data to determine if the sample is representative of the larger population.

He points out that large numbers of participants make it possible to perform statistical manipulations that further ensure reliability and permit the examination of subgroups within the sample.

Another validation tool, says Schmidt, is the replication of landmark studies.

"Because aspects of this topic have been the subject of earlier studies, we can compare our data to that of other researchers and validate their results, as well as our own. And for issues that haven't been examined before, we will be able to offer solid data."

Schmidt says women who currently are pregnant or who recently have given birth can participate in the study by going to the project Web site at www.laborpain.org.