Researchers Using Internet-Based Study to Find Most Effective Ways to Reduce Labor Pain

BUFFALO, N.Y. -- Researchers at the University at Buffalo and Ohio University are using the Internet to collect data from thousands of women from around 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," said investigator William Schmidt, UB assistant professor of psychology.

"The beauty of this procedure," added collaborator Christopher France, professor of health psychology at Ohio University, "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, used distraction, imaging, pain medications and 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," she noted.

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 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.

Schmidt said the researchers welcome participation by women of any age who are pregnant or who recently have given birth. They can participate by going to the project Web site at www.laborpain.org.

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 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 humans 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 and the reproduction of known effects.

"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 upon which to base further investigations."