Pain Management is a medical approach that draws on disciplines in science and alternative healing to study the prevention, diagnosis, and treatment of pain. A recent study showed that 500,000 pregnant women in the United States found that 14% of women filled a prescription for an opioid at least once during the ante partum period and 6% of women received opioids throughout all trimesters. Opioids are drugs that act on the nervous system to relieve pain. This increases the use of narcotics during pregnancy for pain management for pregnant women. Between 1999 and 2010, death has increased fivefold for the pregnant women taking opioids pain relievers in the United States. This article talks about some pharmacological and nonpharmacological approaches in managing painful conditions during pregnancy. It also mentions some treatments of conditions that may be present during pregnancy.
Methodology
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A doula is a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born. Having a doula can increase women self-esteem as well as decrease rate of oxytocin augmentation. Breathing exercise, massaging and relaxing are also nonpharmacological strategies. Pharmacological ways include using opioids to cope with pain management during pregnancy. The advantages of using opioids are an increased ability for woman to cope with labor and the medications may be nurse administered. The disadvantages of using opioids are that the pain is not completely eliminated and frequent occurrence of side effects such as nausea, vomiting and drowsiness
As a doula, I provide educational, physical, and emotional support to clients in a unique and customizable manner. This past year I have continued my education and gained valuable experience by supporting multiple families throughout pregnancy, childbirth, and into postpartum.
The doulas purpose is to help women have a safe, memorable and empowering birthing experience, regardless of what that means for the individual woman. For women who have decided to have a medicated birth, the doula will offer emotional support, informational support and comfort measures through labor and the administration of medications.
Finding out you are pregnant is one of the most exciting and often times scary moments for a woman. After the initial excitement of being pregnant wares off, many woman are left with a lot of fear, anxiety, and apprehension, of their impeding birth. I know when I was pregnant with my first child, I initially had a lot of hear and anxiety about giving birth. It wasn’t until I started doing research on how I wanted to give birth that I started to feel at ease. I decided that for me the best choice was to give birth with a midwife and to have a doula. I choice to use a midwife because I liked the idea of a more traditional birthing method. The midwife I chose had been delivering babies for 20+ years. I liked the idea of using a midwife because they tend to be more client focused and less medically driven. I also chose to use a doula so I had additional support during my labor. So what is a doula?
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.
Chronic pain is a tremendous public health problem, and a costly one. As health care advances and the need for palliative care rises, patients and health care providers are constantly investigating alternative methods of pain treatment and management. Questioning and challenging traditional health policies and practices has created an interest in the use of cannabis as an alternative option to standard opioids, for the management of chronic pain. Cannabis, or marijuana, is a leafy green plant consisting of buds and leaves of the cannabis sativa forma indica plants. Marijuana has been used in holistic solutions for hundreds of years; it has also been especially prevalent among terminally ill cancer patients, who have been reported using it to alleviate symptoms like chronic pain, nausea and depression.
A postpartum doula services are designed to be able to assist in the physical and emotional care of mothers and families in the daysand nights, weeks and months following the birth/adoption of a child. Postpartum doulas are professionals experienced in:
Childbirth is the action of giving birth to a child, it is a process which includes stages such as, the dilation of the cervix, emergence of the baby, then the placenta being expelled. In fact, the mother gets to choose rather or not she has a natural child birth. The mother’s options include, a non-medicated, or a medicated childbirth, in which the mother is prescribed epidural. However, in some instances the mother does not get to choose if she is prescribed with epidural. For example, if the baby is coming sooner than the doctor expected that leads to an emergency birth or if the mother is under eighteen, then the mother may have to give birth unmediated. Epidural is a powerful drug, so any mother under the age of eighteen would need a form
A recent Cochrane systematic review of continuous doula support during childbirth was performed and it was discovered that there were higher rates of vaginal births, lower odds of cesarean delivery, lower regional anesthesia rates, lower instrument-assisted delivery rates, shorter labors, and an overall higher level of satisfaction among the patients. This study was inspired by the Cochrane review, but wanted to mainly focus on Medicaid recipients who did not receive continuous doula support versus beneficiaries that received support during childbirth provided by the company, Everyday
Some consider acetaminophen as the analgesic of choice for the short-term management of the pregnant patient’s oral-facial pain.1,2
We are asked to choose a topic and explore it using nonqualified resources. Why should we do this? It is because we need to cautiously look at every type of “resource” to make sure we are using appropriate and relevant information when it comes to evidence-based care. The amount of information on the worldwide web is truly limitless and much of the posted material is not always suitable or usable when it comes to safe, proper, evidence-based clinical care.
The use of epidural analgesia negatively affect the parent- newborn relationship, because the drug causes complications for both parties. First, the labor becomes prolong, which put stress on the mother and newborn. Also, when the newborn becomes exposed to the drug he or she tend to be sleepy and withdrawn, which does not provide the mother and child a chance to bond. This takes away from the emotional attachment a baby receives from their mother, when their initially placed in their arms. Also, the drug effects the newborn ability to be breastfed, because he or she suck poorly, and tend to be irritable when awake. Further, creating a negative mother-newborn interaction, because the newborn is withdrawn emotionally and physically from their
This article was written for American Journal of Nursing. It talks about how non-pharmacologic interventions can help relieve pain felt by patient in labor. It mentions three categories that were divided based on their proof of effectivenes.
Regardless of the diagnosis or type of pain, effective pain management is a person’s right and adequately assessing, monitoring, preventing and minimizing it should be the top priority in a patient’s care. Significant barriers to adequate pain assessment and management identified in most of the literature reviewed in this paper are the beliefs and attitudes of patients and medical professionals’ flexibility with treatment options. Effective pain management plan has been a topic of interest for several years that continues to be a major problem in the health care system. My research question in this paper will be in post-surgical patients, how does ineffective pain management compared to effective pain management affects wound healing in the recovery period.
One non-regulated provider of service in low-risk obstetrics is the doula. A doula is someone who provides non-clinical support and care to a woman and her partner during childbirth. They provide companionship to the woman and her partner, and consistent continuous reassurance, comfort, encouragement and respect throughout labour and delivery (Doulas of North America, 2010). To this end a doula works with a woman and her family, physicians, midwives and nurses with an aim to enhance communication and understanding among the groups. Currently, although Nova Scotia and nine other jurisdictions in Canada have regulated the practice of
In the situation, Mr. Jensen’s pain was identified as one of the priority problems. The International Association for the Study of Pain (1994) defines pain as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. Thus, pain is an inevitable physical stress with any surgery so much more in external fixation of combined fractures. Also, physical stress contributes to a marked increase in blood glucose levels especially in people with diabetes (Surwitt et al, 1992). It has been determined that the goal of this problem is control/ relief of pain immediately after (30 minutes) of determining the pain through proper pain assessment and management (through medication and complementary therapies).