In-Hospital Childbirth

Giving birth should be a beautiful experience even though delivery can be terrifying and discomfort. Even though women have the decision to choose between having a natural childbirth or get an epidural majority of women give birth at a hospital get an epidural. Make sure when you base your decision on what’s best for your infant and not base off anyone influencing you. What constitutes a “Natural childbirth”? A natural childbirth is when a woman gives birth without any medication. You can choose between having a mid-wife and having an at home birth or you can give birth at the hospital without any medication either way is consider giving natural childbirth. According to Kristeen, an epidural is drugs called local anesthetics, such as bupivacaine, chloroprocaine, or liocaine it numbs the abdomen or pelvic region during labor. An epidural is given when the women is about 4 or 5 centimeters dilated (Cherney, par.2-6). In order to get an epidural you have to get a shot in your spine (lower back). In 1909, the first caudal anaesthesia was given for labor pains by a German obstetrical, Walter Stoeckel, and he study 141 cases of healthy laboring women with epidurals. In 1931, the first catheter was used in an epidural. By the 1940s, epidural were being used sporadically for labor but did not gain true momentum until the 1970s. This was in large part due to the fact that other

In the past, in the United States the majority of women delivered at home with no anesthetics; women might have received assistance through a family doctor, including midwife care (Thomas, 2011). A radical change happened by the 1960s, when hospital childbirths had become the norm, the pain of the experience was reduced by epidural anesthesia controlled by a physician. Pregnant women received education on breastfeeding and other topics during their medical visits (Thomas, 2011).

According to the American Pregnancy organization “more than 50% of woman giving birth at hospitals use Epidural Anesthesia”. These women turn to epidural to relieve the pain of labor; however this decision poses many risks to both mother and child. An epidural is a type of regional anesthesia where pain medication is administered to the lumbar and sacral region of the back near clusters of nerves. The placement allows for nerve impulses to be blocked from the lower regions of the body resulting in decreased sensations. Although the epidural is known for taking pain away it could very well cause it too. Epidurals include the use of various narcotics and have side effects like hypotension, fever, fetal malposition, decreased fetal heart rate, respiratory depression, breastfeeding complications, an increased likelihood of operative vaginal delivery and cesarean and many more. These are the effects faced in result to a procedure that is not definite to work. In Fact “One in every 8 women” (OAA) will experience inadequate pain relief and must venture to other means of medication. Therefore, mothers should abstain from epidural anesthesia due to the risks it poses to themselves and to the fetus.

Therefore, often birth is not very “natural” in the United States, filled with the administration of many drugs to control pain and speed up labor and other interventions like C-sections. However, many women seek a birthing experience that is free or has limited intervention, does not include drugs as a form of pain management, and allows them to be in as much control as possible. I must ensure that I can provide comprehensive care to my patients and that they have access to all the possible approved approaches to managing pregnancy, such as acupuncture for pain management or chiropractic medicine to help with joint pain. In the current system, physicians often practice medicine that operates with the ideology that drugs are the sole method to treat pain and disease (Escape Fire). However, alternative medicine forms have been scientifically proven to be very useful methods of pain management and unfortunately their effectiveness has been limited to the system’s inability to assimilate services like acupuncture and chiropractic medicine into the current system (Escape Fire). There are also other services that I can provide that will help my patients as well, considering that in today’s system “high-cost, intensive medical intervention is rewarded over higher-value primary care, including preventative medicine and the management of chronic illnesses” (The Commonwealth

Specific Purpose: To inform my audience about the different forms of pain management used during childbirth.

According to “Human Sexuality: Diversity in Contemporary America,” women and couples planning the birth of a child have decisions to make in variety of areas: place of birth, birth attendant(s), medication, preparedness classes, circumcision, breast feeding, etc. The “childbirth market” has responded to consumer concerns, so its’ important for prospective consumers to fully understand their options. With that being said, a woman has the choice to birth her child either at a hospital or at home. There are several differences when it comes to hospital births and non-hospital births.

Healthcare providers, like midwifes, want the best outcome for their patients, but because some healthcare providers are more educated on the current hospital practices, they believe that pain medication is the only way to have a minimally painful labor and birth. According to Gaskin (2011), “Mainstream US culture teaches people that pregnancy and birth are illnesses for which hospital treatment is necessary. This cultural conditioning shapes people’s thinking about labor and birth in ways that few question” (p. 51). People do not realize that there could be multiple healthy ways to deliver a baby. In the hospital this semester, I have noticed that one of the major interventions that was pushed on or recommended to women were epidurals. Almost every patient that I saw on the labor and delivery unit had an epidural or had a plan to get an epidural. In post conference, one of the other students told about one of the patients that they encountered. This very young soon-to-be mom did not want any pain medications. According to the student, the nurses, doctor, and anesthesiologist were very adamant upon her getting an epidural because it would relieve her pain and help progress her labor. Even though this patient would reject it each time it was asked, they still continued to ask. This constant

Expectant mothers should educate themselves more about natural birth. This is because there are many consequences and high risk associated with drug intake to release pain and caesarean delivery. This is because if more women are aware about the facts involved with using these medications, they will correctly choose what is best for their own bodies and the health of their babies.

The proposed protocol will include the option of water birth as a method of pain control for low risk full term laboring women in a hospital setting. It is not common practice for maternity wards in hospital settings to have the option of laboring in a birthing pool. Traditionally

The patient will likely endure immense pain during labor throughout their series of contractions and continued dilation. An epidural injection is recommended to ease the pains of labor. The injection site is located in between the Lumbar spinal column, and will negate the pain signals from the waist down that would otherwise be sometimes unbearable to the mother.

“In the United States, approximately 25,000 births (0.6%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Among women who originally intend to give birth in a hospital or those who make no provisions for professional care during childbirth, subsequent unplanned home births are associated with high rates of perinatal and neonatal mortality. The relative risk versus benefit of a planned home birth, however, remains the subject of current debate” (American College of Obstetricians and Gynecologists).

Pharmacological comfort measures can provide partial or complete pain relief. The epidural is the most efficient way of reducing labor pain. Opioids can be given continuously or in intermittent doses at the patient 's request or through the patient controlled pump. There is the potential for these drugs to have some effect on the fetus, such as breathing difficulties that may require assistance through the use of Narcan. Providing pain relief during the labor process is solely the patient’s choice, and as the nurse only support and encouragement should be given for however she chooses to handle the pain. (Jansen, Gibson, Bowles, & Leach, 2013)

Specific Purpose: To inform my audience about the different forms of pain management used during childbirth.

Childbirth can be described as one of the most rewarding and also painful experiences in a woman’s life. Most women choose some type of method to ease pain, however, there has been a lot of controversy over with pain management method is the most effective. According to the CDC (Center for Disease Control), In 2013, there were 3,932,181 births recorded in the United States, 32.7% of those births were surgical procedures. In 2012, 1.36% of recorded births occurred out-of-hospital, meaning these births took place mostly in homes or birthing centers. Without the option of medicine that a hospital provides, how were these women able to manage their pain during labor and delivery. There are many different methods for easing pain during childbirth, some methods involve the use of medicine and surgery, and others include natural techniques, such as hypnosis, Lamaze, and many others. It is a personal preference of the parents over which method is right for the needs of the mother and child. This can be an overwhelming decision for new parents to make because they have to take into consideration the safety of the mother and child, pain management for the mother and desire for medical involvement.

Neuraxial (epidural, spinal, and combined spinal-epidural) techniques are the most effective methods of pain relief during labor [ ]. In addition, physiologic benefits of neuraxial analgesia for the mother and fetus have been demonstrated [ - ]. Neuraxial labor analgesia use has progressively increased in the Western Hemisphere. In the United States, neuraxial labor analgesia for labor rose from 21% to 77% of parturients between 1981 and 2001 [ ]. In the United Kingdom, approximately 33% of parturients chose neuraxial analgesia in 2010 – 2011 [ ].