The “good” epidural: Women’s use of epidurals in relation to dominant discourses on “natural” birth

2020 ◽  
pp. 095935352094480 ◽  
Author(s):  
Sunna Símonardóttir ◽  
Annadís Greta Rúdólfsdóttir

Childbirth is widely recognized to be among the most painful of experiences, and the most common and effective pain relief for birthing women is known to be the use of epidural analgesia. The increase in the use of epidural analgesia for birthing women has been described by some critics as a by-product of the medicalized model of birth, although there remains a notable dearth of research regarding women’s experiences of epidurals. The present paper seeks to address this research gap by examining how first-time mothers in Iceland discuss their intentions concerning pain relief during birth, along with how they construct childbirth-related pain and the use of epidural analgesia in the context of a midwife-led model of care and an institutionalized preference for “natural” birth. The findings demonstrate that, despite initial intentions, most of the women end up having an epidural, and most describe their epidurals as both wonderful and immensely helpful. The dominant narrative about “natural” childbirth being preferable is not fully refuted by this. Instead, the women either align themselves with the ideology of the capable and knowing body or resist and contest this narrative by constructing their birthing bodies as open to, and in need of, assistance.

2014 ◽  
Vol 9 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Senthil Ganapathi ◽  
Gemma Roberts ◽  
Susan Mogford ◽  
Barbara Bahlmann ◽  
Bazil Ateleanu ◽  
...  

Author(s):  
Manisha Thakur ◽  
Nidhi Sagar ◽  
Pooja Tandon

Background: Pain relief is an important issue for women in labour. Epidural analgesia provides safe and effective pain relief. But It has not been fully accepted and is not routinely practiced in most of the centres in developing countries despite of many advantages of this technique. Therefore, this study has been conducted with an objective to assess the knowledge and attitude regarding epidural analgesia among expectant mothers.Methods: A descriptive study was conducted on 60 expectant mothers visiting antenatal OPD at DMC & Hospital, Ludhiana selected by convenience sampling technique. Knowledge assessed by using a structured questionnaire and attitude assessed by 3 point likert scale regarding epidural analgesia. Analysis was done using both descriptive and inferential statistics.Results: The findings of the study revealed that 46.7% expectant mothers had below average level of knowledge, 35% had average level of knowledge and 18.3% had good level of knowledge. 96.7 % had positive attitude and only 3.3 % had negative attitude towards epidural analgesia. Correlation between knowledge with attitude was to be significant (r=0.609; p=0.000).Conclusions: Thus, the study concluded that most of women had below average level of knowledge and but they showed positive attitude regarding epidural analgesia. 


2016 ◽  
Vol 10 (1) ◽  
pp. 30-39
Author(s):  
Roman V. Garjaev ◽  
E. S Gorobets ◽  
P. I Feoktistov ◽  
I. E Karmanov

Neuraxial blockades provide effective pain relief. There are some benefits of prolonged epidural analgesia versus systemic opioids via PCA. Unfortunately, severe hemorrhagic complications can occur after application of these blockades. Methods: poll of all anesthesiologists working in cancer clinic during 2001-2015, search of data in medical archive. Results: it was revealed 2 cases of spinal hematoma following 30,042 epidural anesthetics and 0 cases among 8,126 spinal techniques. Both of complications were associated with evidence of hemostatic abnormality, there were no neurologic symptoms; patients had a conservative treatment and good outcomes. Conclusions: the incidence of spinal epidural hematoma after prolonged epidural analgesia was 0.67 per 10,000 (95% CI 0.57-0.76per 10,000), after spinal anesthesia - 0 per 8,126.


2017 ◽  
Vol 5 (2) ◽  
pp. 80
Author(s):  
Dedi Fitri Yadi ◽  
Muhamad Ibnu ◽  
Ezra Oktaliansah

Analgesi epidural yang optimal akan menghasilkan penanganan nyeri yang baik dengan efek samping minimal dan meningkatkan kepuasan pasien. Sampai saat ini belum terdapat data di Indonesia khususnya di wilayah Jawa Barat mengenai penggunaan anestesi lokal dan adjuvan pada analgesi epidural. Tujuan penelitian ini mecari data mengenai penggunaan anestesi lokal dan adjuvan yang digunakan oleh dokter spesialis anestesi di wilayah Jawa Barat pada tahun 2015. Penelitian ini dilakukan pada bulan Agustus hingga September 2016 di Departemen Anestesiologi dan Terapi Intensif Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini bersifat deskriptif dengan pengambilan data menggunakan kuesioner dan pendekatan cross sectional. Kuesioner dikirimkan kepada 120 dokter spesialis anestesi di Jawa Barat melalui jasa pos dan 30 kuesioner diberikan langsung kepada dokter spesialis anestesi yang bekerja di Rumah Sakit Dr. Hasan Sadikin Bandung. Angka respons yang didapatkan sebesar 47,3%. Hasil penelitian ini didapatkan dokter spesialis anestesi di Jawa Barat yang masih melakukan analgesi epidural pada tahun 2015 sebesar 73,2%. Obat anestesi lokal yang paling banyak digunakan untuk analgesi epidural adalah bupivakain sebesar 94,23%. Konsentrasi terbanyak 0,125% sebesar 82%. Adjuvan yang paling banyak digunakan adalah fentanil sebesar 96,9%. Simpulan penelitian ini sebagian besar dokter spesialis anestesi masih menggunakan epidural sebagai analgesi sehingga bupivakasin dan fentanil menjadi obat terbanyak yang digunakan.Kata kunci: Analgesi epidural, anestesi lokal, adjuvan  Local Anesthetic and Adjuvan Used for Epidural Analgesia in West Java in 2015Optimal analgesia epidural technique should promote effective pain relief with minor adverse event and major pastient satisfactory. Up till now, there was no data about local anesthetic and adjuvan agent used for epidural analgesia by anesthesiologist in Indonesia, especially in West Java. The purpose of this study to find data regarding local anesthetic and adjuvan agent used for epidural analgesia by anesthesiologist in Indonesia, especially in West Java in 2015. This research was conducted from August to September 2016 in the Department of Anesthesiology and Intensive Therapy Dr. Hasan Sadikin Hospital in Bandung. This is a descriptive study with cross sectional approach using questionairre. Questionairre was sent to 120 anesthesiologist through mail and 30 questionairre was given to anesthesiologists worked at Dr. Hasan Sadikin General Hospital Bandung. Response was obtained 47.3%. This study shows that there were 73.2% anesthesiologist performed epidural analgesia in 2015. The most  local anesthetic used in epidural blockade was bupivacaine, amounted 94.23% and the most concentration is 0.125%, amounted 82%. The most used adjuvant was fentanyl, 96.9%. In Conclusion, most of the anesthesiologist used epidural as an analgesia so bupivacaine and fentanyl used most frequentKey words: Epidural analgesia, local anesthetic, adjuvan


PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 218A-218A ◽  
Author(s):  
Maya Bunik ◽  
Jennifer Leifermann ◽  
Jessica R. Ryan ◽  
Anna Furniss ◽  
Sheana Bull

2019 ◽  
Vol 9 (7) ◽  
pp. 150 ◽  
Author(s):  
Yongzhi Huang ◽  
Binith Cheeran ◽  
Alexander L. Green ◽  
Timothy J. Denison ◽  
Tipu Z. Aziz

Deep brain stimulation (DBS) of the anterior cingulate cortex (ACC) was offered to chronic pain patients who had exhausted medical and surgical options. However, several patients developed recurrent seizures. This work was conducted to assess the effect of ACC stimulation on the brain activity and to guide safe DBS programming. A sensing-enabled neurostimulator (Activa PC + S) allowing wireless recording through the stimulating electrodes was chronically implanted in three patients. Stimulation patterns with different amplitude levels and variable ramping rates were tested to investigate whether these patterns could provide pain relief without triggering after-discharges (ADs) within local field potentials (LFPs) recorded in the ACC. In the absence of ramping, AD activity was detected following stimulation at amplitude levels below those used in chronic therapy. Adjustment of stimulus cycling patterns, by slowly ramping on/off (8-s ramp duration), was able to prevent ADs at higher amplitude levels while maintaining effective pain relief. The absence of AD activity confirmed from the implant was correlated with the absence of clinical seizures. We propose that AD activity in the ACC could be a biomarker for the likelihood of seizures in these patients, and the application of sensing-enabled techniques has the potential to advance safer brain stimulation therapies, especially in novel targets.


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