May 30, 2003

TENS and Homeopathy - are we fooling women?

The question about the implications of placebos in relation to dealing with labour pain came up again yesterday. I was asked about the use of TENS and also what I thought about using homeopathy for labouring women.

Since there is no scientific evidence that TENS eases labour pain or increases endorphin levels (see the Cochrane Library for the relevant Systematic Review) I have little time for it. It is widely used in Britain and promoted heavily in the pregnancy magazines, chemists shops and even by childbirth organisations. The prevailing view seems to be that it has no side effects and may do some good as a placebo, so why not promote it?

Homeopathy is another can of worms. There is also no scientific evidence that it works, and no-one has yet been able to prove the basis on which it is founded. It again probably works as a placebo, and of course, it is harmless, since the remedies contain nothing but water. I have no objection to people using homeopathy because water is safe to drink, and there is no chance of side effects, overdosing or interactions with other medications.

However, both of these approaches to managing labour rely on women’s fear of pain, bogus claims and the gullibility of women who believe they cannot manage labour and birth without some kind of prop. If the remedy works then they will praise the treatment for its effectiveness. If it doesn’t work, they will just go on to use something else (TENS has never been shown to reduce the rate of epidural use or other drugs, for example).

Why are these crutches being so enthusiastically embraced, and particularly by midwives? What’s wrong with women using these things - does it matter that they are only working as placebos? I believe that it is these kinds of props that feed into the prevailing culture of “learned helplessness” that afflicts many women (and midwives). Instead of recognising women’s inner strengths and capabilities to give birth well, these gadgets reinforce the idea that women can’t manage labour without some external assistance, and as a result, the “victim” mentality, and “poor me” attitudes are reinforced.

I can accept that very, very occasionally, a woman may be so lacking in self belief or appropriate emotional or physical support from others that she needs to rely on these substitutes for care. The popularity of these methods and their growing acceptance and promotion, especially by health professionals suggests to me that women are being cared for by people who either have little faith in birthing women or are lacking in skills to support women during labour using natural means (such as promoting endorphin release).

I think it is time to stop fooling ourselves that women needs these props for labour. Right now, midwifery is undergoing a crisis of confidence and this is rubbing off on women. Let us celebrate our strength and creative capacity rather than selling ourselves short and giving credit to shonky products that offer an illusion of effectiveness. Women need midwives who believe they can give birth using their own resources, and midwives need to see how well women manage labour without external aids. If we are to reclaim birth from the drug companies and the medical men, we need to have a united, confident, visionary belief in the innate safety and power of birth. Without this unshakable faith, we are easy pickings for those who would rather see birth (and women) medicalised and exploited for their money making potential.

Posted by andrea at May 30, 2003 05:01 PM

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Hi Andrea: I actually agree with you about this one, both Tens and Homeopathy being placebos if they work at all. However, while i would never recommend either to women in my care, I couldn't in all conscience actively campaign against their use. From my experience the women who use say homeopathics really do believe in their effectiveness and, I don't see them (the women)coming from a place of disempowerment. I think they kind of like the magic or otherworldliness of homeopathy. In any case it is a belief system and I feel I should be sensitive and respectful to it (but now i've blown my cover)and so long as it does no harm I have no problem. In all honesty I have never met a women who used homeopathics during her labour who felt disempowered, quite the contrary. Obviously (to you and me)their body needed nothing extra, they did do it themselves. Do I feel they give too much credit to the treatment, yes; do I wish they wouldn't prosletise, yes; and do i think it is a rip off, yes. I am amazed at the number of midwives who embrace homeopathy, but I have met some amazing, and brilliant, and lovely midwives who do. I think it is just another lens for viewing the world, and a harmless one, for the main. However, maybe I am being too sensitive. Or just choosing my battles.

I do get upset when I feel they can do harm through omission of the real medication/treatment, like homeopathic vaccinations and homeopathic uterine tonics/oxytocics for PPH with no real oxytocic at hand, and I am sure there are other incidences
where homeopathics may be used instead of a needed medication.

marilyn

Posted by: Marilyn Kleidon on May 30, 2003 09:00 PM

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most of the time that TENS does not appear to work for the women is when she hasn't started to use it early enough in labour and /or not using it correctly, forgetting to turn up the frequency and intentitsity. personnality i used it solely for the labour and the delivery of my 3rd child. the labour was relatively pain free.

Posted by: zoe on June 9, 2003 01:27 AM

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Actually, I disagree. I have only been to a homeopath once, to treat which was for me a very embarrassing symptom. The homeopath in question gave me pills to cleanse my liver. I felt 'clean' from the inside in the next two days. While I am a sceptic, if this is any proof that homeopathy works, then I am willing to consider that homeopathy can work for labour. I can't offer a scientific explanation, as to why it works-it is laughable on that basis-but many people have successfully treated many conditions successfully.

Posted by: sian on October 3, 2003 07:29 AM

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I am very much a proponent and can vouch for the effectiveness of homeopathy. I have a horse that has severe COPD (an asthma like condition that causes narrowing of the airways.) that showed no response to the typical arsenol of corticoid steroids, bronchiodilators, and anti-histamines whose condition clears up instantly with homeopathics (I of course had to discover this after spending over 500 dollars of veterninary bills.) And I doubt very much that my mare suffers from any "placebo" effect. I agree that scientific research in the area of homeopathy is lacking, and generally done poorly. Most of the studies I've seen are too specific and like conventional medicine (i.e. the study of one single remedy for everyone who has a headache) when homeopaths themselves look at an individual's complete symptom and health picture before prescribing, and not just basing it on one particular "common complaint."

Posted by: stacey on October 14, 2003 12:54 AM

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I am a homoeopath.In view of my personnal experience over two decades, I however believe that Homoeopathic remedies do work in reality. as for there is a question of scientific proof, how they work? i don't care. Why?. because there are lot of facts which our science do not and can not proove. As Hahnemann (The originator of Homoeopathy) said, You try these medicines and if you get the positive results then believe. So why not to try upon yourself and your family members?

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