Women's experience of pain during childbirth. These elements could also inform the content of antenatal education, decision aids and prenatal support groups. Pharmacological methods of pain control are also included. Indeed, several women, such as Naomi and Alison, saw choosing an epidural to relieve their pain as a way of preventing them from losing control or of regaining the control they had lost because of the pain they were in. Firstly, during pregnancy women expressed a degree of uncertainty about the level of pain they would experience in labour and the effect of different methods of pain relief.
London: Royal College of Midwives; 2012. Cheshire: Books for Midwives Press; 1998. However, none reported discussing these concerns with their midwives, the implication being that there was not enough time within their antenatal appointments to cover the information the women needed. For some women in this study the process of writing a birth plan was a positive step to enable them to consider their options, express a preference or a hope and to act as an aid to them being engaged in the decision making process during labour. Another important factor impacting on the decision making process is what is important to the woman.
During the antenatal interviews the women tended to focus mainly on pharmacological interventions rather than non-pharmacological alternatives, although several women did talk about the importance of breathing and relaxation and the benefits that continuous support could provide in management of their pain. Are there any other issues that have not been raised today that you want to raise about pain relief? Neither primiparous nor multiparous women were able to make decisions. Labor Pain Management Other Than Neuraxial: what do we know and where do we go next? Choice, Autonomy, and childbirth education. Book Condition: This book is in very good condition and will be shipped within 24 hours of ordering. The issue of natural methods of pain management was explored in the interviews, but the design of the study was such that the interviews focused primarily on issues raised by the women themselves.
Expectations and experiences of pain in labour: Findings from a large prospective study. Have you made any decisions about which methods of pain management you are going to use? Birth your way: Choosing birth at home or in a birth centre. A more appropriate approach would be to ensure that all women are fully informed antenatally about their relevant pain relief options, including both coping strategies and pharmacological options as recommended by the guidelines. Other women, like Gail and Lynne, felt a birth plan may actually show distrust of the healthcare professionals and that it was better to hand the decision making over to them. Midwife-led continuity models versus other models of care for childbearing women.
The aim of this paper is to draw upon interviews with women to explore how they can be better supported in preparing for, and making, decisions during pregnancy and labour regarding pain relief. Purposive sampling was used to capture a range of different views and experiences e. Information given to women needs to contain details on the effectiveness of all available options of pain management both pharmacological and non-pharmacological , the risks, benefits and consequences of the options, and the appropriate points in labour for particular forms of pain relief to be administered. This adds further weight to the suggestion that ultimate decisions on pain management ought to be left until labour has started, which would enable a woman to make decisions in response to the level of pain being experienced and the control she is able to have over both the pain and the situation around her. Results Three main themes emerged from the data.
This approach would enable women to make decisions based on the knowledge they have gained during their antenatal preparation, and on the pain they are actually experiencing, with the full support of their midwife. One way women currently try to ensure they are informed about their options for labour is to attend antenatal education classes. It would be more beneficial to concentrate efforts on better informing women and on engaging them in discussions around their values, expectations and preferences and how these affect each specific choice rather than expecting them to make to make firm decisions in advance of such an unpredictable event as labour. They decided not to write a birth plan. I got into the delivery room she was very, very good.
Revisiting the critique of medicalized childbirth: a contribution to the sociology of birth. Communication and decision-making in labour: do birth plans make a difference? The cover may have some limited signs of wear but the pages are clean, intact and the spine remains undamaged. Women identified the importance of support from the delivery suite midwives in helping them to achieve the birth they wanted. Maidenhead, England: Open Univiersity Press; 2005. All authors read and approved the final manuscript.
Discussion An overarching finding identified throughout the results of this study was that women felt that they were not in a position to make decisions about their plans for pain management in advance of labour. If women begin to discuss their values at an early stage of their pregnancy, this will also help midwives explore with women how their values and subsequent expectations are formed, and ensure that they are well informed and based on accurate, evidence-based information. They reported lacking knowledge on how to use non-pharmacological methods of pain management, such as breathing and relaxation, alongside limited knowledge on how painful labour would be and how the various forms of pain relief would affect their control. In this situation the woman still takes part in the decision, but the midwife explains the best options available, given the stage of labour and the ability of the woman to cope with pain, and supports her in making a decision. If you're new to the site,.
Using the site is easy: either search for a specific title or browse our extensive catalogue by area s of interest; once you're logged in, you can request your free digital or print inspection copies for consideration. Those advertisers use tracking technologies to collect information about your activity on our sites and applications and across the Internet and your other apps and devices. Women are encouraged to make decisions about pain relief in labour in the ante-natal period based upon their expectations of what labour pain will be like. The nature and management of labor pain: part I. Finally, women discussed their perceived levels of control, both desired and experienced, over both their bodies and the decisions they were making. This cause for concern was exacerbated by the fact that, despite the uncertainty women had about the level of pain in labour, they were being asked during their antenatal care to make choices about which pain relief they would choose. Secondly, women reflected upon how decisions had been made regarding pain management in labour and the degree to which they had felt comfortable making these decisions.
The second issue that arose relates to gaps in antenatal information provision to women about pain management options. The control of pain in labour. A major strength of this research is that it explores decision making in the specific context of the provision of maternity care and hence addresses the uncertainty that women face throughout pregnancy, given the difficulties in predicting the sort of labour they will have and how they will respond to pain. Evidence Based Guidelines for Midwifery-Led Care in Labour. Many women find this planning difficult. The discussions with the women, although aided by the topic guide, were determined by the women themselves and as such this paper focuses on the issues raised by them. Validation of a decisional conflict scale.