Expert: Dr Ian Jackson - please note UK based - 1/12/2005

Question
I am a teacher working on a research project about the impact of technology. What do you think the recent innovations in pain management - the epidural, the morphine pump - have done to change how our culture sees illness and trauma? Has it had any impact on mother and child bonding? Thank you for responding - Linda McDonald

Answer
Wow big questions! This has to be a personal opinion.

I'm not an expert on chronic pain and so will avoid speaking about that side of things.

Mother child bonding? I am assuming you mean do epidurals have an effect?

From personal experience over the last 20 years (god that makes me old!) I believe that analgesic technique during labour has an effect on 'bonding' but only on a relatively small proportion of mothers. What do I mean by this?

Well I think the vast majority of mothers would bond well with their child no matter what happened (within reason). This is only natural and the way it should be.
However another fairly large proportion now benefit from epidurals and the avoidance of the dreaded 'twilight sleep' (now that is old), the use of opioids and even entonox. They are a group that would have suffered badly from side effects of the 'old techniques'. Bonding may well be easier in this group - no painful memory to get in the way.
Then there is probably a small group who we fail - despite best efforts of those involved the epidural doesn't work or something else happens. On the whole this group still bond well (as mentioned above) however some may be adversely effected.

'What do you think the recent innovations in pain management - the epidural, the morphine pump - have done to change how our culture sees illness and trauma?'

I don't think our culture sees illness or trauma any differently because of technology except.. expectations are increased, people increasingly are told to expect perfect care, perfect pain control etc. However despite technology many things are still impossible. For instance we cannot make every epidural work - 90-95% yes but the rest no. So we cannot promise perfect pain relief.

However overall I don't think the technology you speak about (epidurals, pain control pumps) are changing our culture much. It is information from education, the internet, newspapers and largely the TV that is changing how we see illness. The increase in programmes linked to health either serious documentaries or soaps such as Casualty, Scrubbs all have an effect.

Sorry perhaps that wasn't helpful, best of luck with the project