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Re: casual research questionFrom: Henry Gregor (henrygregor@yahoo.com)Fri Jun 29 16:35:38 2007
"westsidebirthservice@juno.com" <westsidebirthservice@juno.com> wrote: Or I once read a research article published in the late 90's (can't remember the article off the top of my head) that said that physicians don't do an informed consent re: side effects of epidural because they (the physicians) think the women would rather trade pain relief for infomation. I'm trying to be provocative here-- interested in the dialogue. Louana I agree you're provocative with that one Louana, perhaps even condescending and insulting to our colleagues in that arena. The anesthesiologists and their professional organization(s) have been in the forefront of safety and risk management (AKA the home of well documented informed consent and procedure monitoring processes). Most people involved in risk management programs that I have interacted with over the years give very high marks to the attention given to risks benefits documentation shown by those who provide the analgesia/anesthesia. It'd be great if ours and other medical specialties could duplicate their efforts. Beyond that, I have seen very few birthing facilities or childbirth education programs that didn't present the relevant information in well crafted presentations. As for trading pain relief for dealing with pain by support and respect for the role of pain in childbirth, that seems to me a modern day equivalent of the Biblically cited disapproval heaped on Queen Victoria and her attendants when she used analgesia (ether, I believe) in childbirth. I think women deserve to be respected for their choices whatever they may be. I always chuckle when I recall what my dentist told her labor nurses when they implored her to withdraw her request for an epidural. She offered them all a fast track appointment for a natural dentistry root canal without analgesia but all the support they'd like. It was her expressed belief that she didn't find either labor or dental pain to be ennobling and felt very much abused by her attendants who did not share that viewpoint...at least as far as the labor pains went. I also seem to recall it was Dr. Redmond, she who did such marvelous work re PIH and chronic hypertension in pregnancy, in England, through the 70's and 80's, who presented data, as did others, that unrelieved severe pain levels in laboring women could adversely affect acid base levels in their fetuses. I don't mind discussing the pros and cons of patients using/choosing one method of pain relief over another, but it does irritate me when the tenor of such discussions takes on the character of a witch hunt, which, to be collegially open, is what your phrasing suggests to me. I think the failure of Lamaze (as in the psychoprophylaxis of pain in labor) is pretty self evident, given the legions of laboring Lamaze "graduates" who request medical relief in labor. That observation is, to me, even more signigicant when one reflects on the pattern of steadily increasing available prenatal educational info and opportunities of the last couple of decades. The fact that such increased quantities of information and prenatal education options and huge media attention to the subject haven't changed women's choices speaks for itself. Just an opinion. Hank --------------------------------- Be a better Globetrotter. Get better travel answers from someone who knows. --------------------------------- Yahoo! Answers - Check it out. -- ---------------------------------
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