Epidural versus non-epidural or no analgesia in labour

Access or Egress? Questioning the “Ethics” of Ethics Committee Review for an Ethnographic Doctoral Research Study in a Childbirth Setting

“…In addition, Walsh (2009) has commented that the rise in epidural rates in the United Kingdom (which is also mirrored in Australia, see Lain et al, 2008) could be due less to an increased requirement for analgesia than to a fragmented maternity system that leaves women feeling unsupported. Given that epidural analgesia carries certain risks with use (Anim-Somuah, Smyth & Howell, 2005;Gaiser, 2005;Rahm, Hallgren, Hogberg, Hurtig, & Odlind, 2002;Jordan et al, 2009;Wang, Shen, Guo, Peng & Gu, 2009) and women are not always well-informed of these (Heinze & Sleigh, 2003), there is therefore a need for further investigation in this area, which our research aims to address.…”

Physical and Psychological Aspects of Pain in Obstetrics

“…Analgesia can be readily converted to anaesthesia by increasing the local anaesthetic concentration, facilitating instrumental or caesarean delivery. Labour analgesia benefits patients with hypertension and some types of cardiac disease example mitral stenosis because it blunts the haemodynamic effects that accompany uterine contraction are increased preload, tachycardia, increase systemic vascular resistance, hypertension and hyperventilation [31]. For mobile epidurals affects motor function leading to weakness of the lower limbs, decrease the concentration and adding an opiate provides good pain relief with sparing of motor function and ambulatory epidural service is not yet available in all centres [3].…”

“…Painful contractions may lead to maternal hyperventilation and respiratory alkalosis, which in turn shift the oxygen haemoglobin dissociation curve to the left, decrease delivery of oxygen to the foetus [31]. The pain of labour is associated with reflex increase in blood pressure, oxygen consumption, and liberation of catecholamines, all of which could adversely affect uterine blood flow.…”

Comparing Maternal and Neonatal Side Effects of Natural Vaginal Delivery under Neuro-Axial Analgesia with Usual Vaginal Delivery and Cesarean Section: A Primary Single Center Study

“…Propagating NVDs with analgesia interventions can be considered as a way to increase interest in having natural deliveries (1). Among analgesia methods, epidural analgesia, spinal analgesia, a combination of epidural and spinal analgesia (spinal or neuro-axial anesthesia), as well as inhaled drugs can be mentioned (9). Although relieving pain is one of the most important advantages of spinal analgesia (9), several side effects, such as slowing down the progress of natural childbirth, were also reported in this type of analgesia.…”

“…Among analgesia methods, epidural analgesia, spinal analgesia, a combination of epidural and spinal analgesia (spinal or neuro-axial anesthesia), as well as inhaled drugs can be mentioned (9). Although relieving pain is one of the most important advantages of spinal analgesia (9), several side effects, such as slowing down the progress of natural childbirth, were also reported in this type of analgesia. Furthermore, other side effects including a prolonged postpartum convalescent period after delivery, headache, backache, low APGAR scores in neonates, and some respiratory problems were reported after performing spinal analgesia (10).…”