• Corpus ID: 55325234

Pain and epidural use in normal childbirth

  title={Pain and epidural use in normal childbirth},
  author={Denis Walsh},
  • D. Walsh
  • Published 1 September 2009
  • Medicine
With epidural rates doubling in the UK over the past 20 years, the impact on normal labour and birth is profound. Changes have also occurred in wider birthing milieu, such as the rise of a risk discourse, the diminishing of a ‘rites of passage’ meaning to birth, the growth of obstetric anaesthetic services and the advent of informed choice in maternity care policy. This paper discusses these issues and argues that inadequate service provision and an impoverished approach to labour pain rather… 

Tables from this paper

Documenting risk: A comparison of policy and information pamphlets for using epidural or water in labour.
An exploration of the benefits and drawbacks of intrapartum pain management strategies
A review of relevant literature discusses an array of options and their clinical sequelae from a midwifery perspective, with equal attention to psychological, physiological and pharmaceutical methods.
The Epidural in Context
This chapter presents a historical introduction to birth analgesia and the influence of scientific and medical discourse on understandings of women’s bodies, influencing the ways in which women
Functional discomfort and a shift in midwifery paradigm.
  • Ruth Sanders
  • Medicine
    Women and birth : journal of the Australian College of Midwives
  • 2015
Caesarean-section, my body, my choice: The construction of ‘informed choice’ in relation to intervention in childbirth
The notion of choice, especially of informed choice, is a central tenet of maternity services in most western countries; it also underpins debate about rising rates of intervention that are now a
A critical literature review of epidural analgesia
This critical literature review provides an alternate reading of epidural text and challenges some of the assumptions made about epidural analgesia, and the practices that stem from these beliefs.
Paradox of the institution: findings from a hospital labour ward ethnography
Findings from the study showed how institutional surveillance led to an institutional momentum that in its attempt to keep women safe actually introduced new areas of risk, a situation which is named the Paradox of the institution.
This study applies best practices to develop a model LDR room that takes into account current American codes and standards and includes features that facilitate non-pharmacological pain relief techniques.
Do stress and anxiety in early pregnancy affect the progress of labor: Evidence from the Wirral Child Health and Development Study
Investigation of associations between antenatal anxiety and pregnancy‐specific stress, and labor progression was assessed by duration and use of augmentation, found evidence of association is inconsistent.
Experiences of Pleasurable Childbirth: Uncovering a Blind Spot in Anthropology
Anthropology Anna Caffrey completed her MSc in Medical Anthropology at University College London in 2010 and now lives in Houston, Texas, where she works as a Certified Professional Midwife.


Has medicalisation of childbirth gone too far?
  • W. Camann
  • Medicine
    BMJ : British Medical Journal
  • 2002
The widespread use of regional analgesia in labour should be celebrated as one of the blessings of having a baby in this millennium and should also be accompanied by the attitude among all obstetric and anaesthetic care providers that there is nothing “wrong” with women who choose natural childbirth.
The natural caesarean: a woman-centred technique
A ‘natural’ approach that mimics the situation at vaginal birth is described, allowing the parents to watch the birth of their child as active participants and the baby to be transferred directly onto the mother’s chest for early skin‐to‐skin contact.
The nature and management of labor pain: part I. Nonpharmacologic pain relief.
Nonpharmacologic methods of pain relief such as labor support, intradermal water blocks, and warm water baths are effective techniques for management of labor pain and an increased availability can provide effective alternatives for women in labor.
The nature and management of labor pain: part II. Pharmacologic pain relief.
Research is needed regarding which pain-relief options women would choose if they were offered a range of choices beyond epidural analgesia or parenteral opioids, and little evidence supports the use of one agent over another.
Epidural or no epidural anaesthesia: Relationships between beliefs about childbirth and pain control choices
Results showed that differences in beliefs about childbirth are related to pain control choices, and women who laboured without an epidural had low fear of childbirth, an internal locus of control for childbirth, and a desire to actively participate in the childbirth process.
A National Survey of Safe Practice With Epidural Analgesia in Obstetric Units
Many units are already following the guidance from the NPSA but nearly one in four units have experience of wrong route drug errors related to confusion between systems for intravenous and regional drug administration.
New reasons and new ways to study birth physiology
  • M. Odent
  • Biology
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 2001
Decision Making in Laboring Women: Ethical Issues for Perinatal Nurses
This descriptive qualitative study asked what factors influence a woman's change in her stated birth preference from an unmedicated birth to a medicated birth, and reflected on the change.