Sentences with phrase «epidural analgesia in»

Not exact matches

Patient - controlled epidural analgesia is currently only available in one - fifth of hospitals in the UK due to the expensive costs of the equipment needed.

In many hospitals, epidural analgesia is routine and is provided to more than 90 percent of all women who are in labor in that hospital.&raquIn many hospitals, epidural analgesia is routine and is provided to more than 90 percent of all women who are in labor in that hospital.&raquin labor in that hospital.&raquin that hospital.»

Dozier et al (2013) also identified the link between epidural use and limited breastfeeding duration, but their study was substantial in that they looked at all the contributing, or covariate, factors in the the relationship between epidural analgesia and breastfeeding including the associated use of IV fluid and synocinin.

As epidural analgesia has been shown in randomised trials to reduce the likelihood of a normal vaginal delivery this could contribute to the variation in normal delivery rates seen.28 Indeed, medicalisation of the environment could be the dominant effect in the United Kingdom, over-riding potential benefits of continuity and «knowing your midwife.»

«In the subgroup of women with spontaneous onset of labour and vaginal deliveries, after controlling for other obstetric and demographic factors, epidural analgesia but not narcotic analgesia was significantly associated with reduced breastfeeding duration (adjusted hazard ratio 1.44, 95 % confidence interval 1.04 - 1.99).»

Flint and colleagues suggested that when midwives get to know the women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected population, has a rate for normal vaginal births of 77 %, with 35 % of women having a home birth.23 A review of care for women at low risk of complications has shown that continuity of midwifery care is generally associated with lower intervention rates than standard maternity care.24 Variation in normal birth rates between services (62 % -80 %), however, seems to be greater than outcome differences between «high continuity» and «traditional care» groups at the same unit.25 26 27 Use of epidural analgesia, for example, varies widely between Queen Charlotte's Hospital, London, and the North Staffordshire NHS Trust.

What is not yet clear is the relative contribution to birth outcomes of health professionals» attitudes, continuity of carer, midwife managed or community based care, and implementation of specific practices (such as continuous emotional and physical support throughout labour, use of immersion in water to ease labour pain, encouraging women to remain upright and mobile, minimising use of epidural analgesia, and home visits to diagnose labour before admission to birth centre or hospital).

The odds of receiving individual interventions (augmentation, epidural or spinal analgesia, general anaesthesia, ventouse or forceps delivery, intrapartum caesarean section, episiotomy, active management of the third stage) were lower in all three non-obstetric unit settings, with the greatest reductions seen for planned home and freestanding midwifery unit births (table 4 ⇓).

The proportion of women with a «normal birth» (birth without induction of labour, epidural or spinal analgesia, general anaesthesia, forceps or ventouse delivery, caesarean section, or episiotomy9 10) varied from 58 % for planned obstetric unit births to 76 % in alongside midwifery units, 83 % in freestanding midwifery units, and 88 % for planned home births; the adjusted odds of having a «normal birth» were significantly higher in all three non-obstetric unit settings (table 5 ⇓).

Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia.

J. A. Thorp et al., «The Effect of Continuous Epidural Analgesia on Cesarean Section for Dystocia in Nulliparous Women,» Am J Obstet Gynecol 161, no. 3 (1989): 670 — 675.

Furthermore, preferring a birth with midwife - led care — both at home and in hospital - was associated with lower rates of induced labor and lower rates of epidural analgesia.

1 More than a century later, epidurals have become the most popular method of analgesia, or pain relief, in US birth rooms.

The other Swedish group found that newborns exposed to labor analgesia (mostly opiates, but including some epidural - affected newborns) were also disorganized in their pre-feeding behavior — nipple massage and licking, and hand sucking — compared to unmedicated newborns.115

Nulliparas» preferences for epidural analgesia: Their effects on actual use in labor.

A recent study comparing women's choices of pain relief in midwife - led and consultant - led units in Ireland showed that when women were offered other options such as hydrotherapy and transcutaneous electrical nerve stimulation, fewer women chose epidural analgesia [9].

This showed that women carrying their own case notes may lead to an increase in assisted deliveries and a slight increase in epidural analgesia (low - certainty evidence).

We used reliable methods to assess the quality of the evidence and looked at seven key outcomes: preterm birth (birth before 37 weeks of pregnancy); the risk of losing the baby in pregnancy or in the first month after birth; spontaneous vaginal birth (when labour was not induced and birth not assisted by forceps; caesarean birth; instrumental vaginal birth (births using forceps or ventouse); whether the perineum remained intact, and use of regional analgesia (such as epidural).

In the Consortium on Safe Labor study discussed earlier, although the mean and median duration of the second stage differed by 30 minutes, the 95th percentile threshold was approximately 1 hour longer in women who received epidural analgesia than in those who did not (20In the Consortium on Safe Labor study discussed earlier, although the mean and median duration of the second stage differed by 30 minutes, the 95th percentile threshold was approximately 1 hour longer in women who received epidural analgesia than in those who did not (20in women who received epidural analgesia than in those who did not (20in those who did not (20).

I have heard first - hand stories of women being denied epidurals, lied to about the effects of epidural analgesia, and not being provided with proper informed consent about the risks of going to 42 weeks at her 41 week appointment (as in, the mother wasn't told anything that was in the College of Midwives» sample consent document about increased risk of stillbirth).

After adjustment for maternal age, lone parent status, income quintile, use of any versus no substances and parity, women in the home birth group were less likely to have epidural analgesia (odds ratio 0.20, 95 % confidence interval [CI] 0.14 — 0.27), be induced, have their labours augmented with oxytocin or prostaglandins, or have an episiotomy.

In a multivariate analysis controlling for maternal age, lone parent status, income quintile, parity or use of any substances (illicit drugs, alcohol or tobacco), women who intended to have home births were significantly less likely to be exposed to induction or augmentation of labour, epidural analgesia, episiotomy or cesarean section (Table 3).

Sarah Buckley has asked and answered this question, and reveals the unintended consequences of numerous widespread practices, including scheduled birth — induced labor or planned cesarean; disturbance and excessive stress during labor; synthetic oxytocin (Pitocin); opioids and epidural analgesia for labor pain; early separation of mother from infant or wrapping the infant in a blanket to be held (i.e., no skin - to - skin contact); breastmilk substitutes, and many more.

Effects of intrapartum oxytocin administration and epidural analgesia on the concentration of plasma oxytocin and prolactin, in response to suckling during the second day postpartum.

Anim - Somuah, M., Smyth, R.M.D., and Howell, C.J. (2010) Epidural versus non-epidural or no analgesia in labour (Review).

For example, the Cochrane Review (Anim - Somuah, Smyth and Howell, 2010) on epidural versus non epidural, or no analgesia in labour, outlined three common downsides of epidural:

As with systemic analgesia, use of opioids in an epidural block increases the risk that your baby will experience a change in heart rate, breathing problems, drowsiness, reduced muscle tone, and reduced breastfeeding.

• Demonstrated expertise in monitoring patients» post-surgical vital signs to ensure their stability and wellbeing • Deep insight into operating equipment such as cardiac monitors and pulse oximeters and quickly diagnosing problems and responding promptly • Proficient in handling pain management by ensuring a thorough comprehension of pain medications and safe ways of administering them • Adept at handling patient - controlled analgesia pumps and IVs and epidural anesthesia to ensure patient comfort • Qualified to monitor patients for adverse reactions to anesthesia and pain management medications by employing deep insight into anesthesia and how it affects the human body • Hands - on experience in handling critical care procedures post-surgery to ensure increased patient safety and comfort • Proven ability to manage post-operative pain by administering pain medication and assisting patients recover from the effects of anesthesia • Competent at handling patients with post-operative nausea and vomiting by ensuring that steps are taken to ward off respiratory pneumonia and other life threatening conditions • Unmatched ability to assess patients» conditions in post-surgical environments and implement post-surgical treatment plans to ensure increased chances of patient recovery and comfort