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The Royal College of Obstetricians and Gynaecologists (RCOG) believes that women should have access to a range of pain relief options for labour. This is an essential part of comprehensive care in our maternity services.
Women should also have available to them, good antenatal education to ensure they are informed about all methods of pain relief to allow them to make an informed choice about what they would like to use in labour. This should include information about mobilisation, the use of water, entonox as well as information about epidurals. To enable this, more midwives are needed in the workforce so that women are appropriately counselled on their birth plan during their antenatal clinics.
The decision to have an epidural analgesia should lie with the woman, in consultation with her midwife or obstetrician.
Pain during childbirth is very subjective and differs from woman-to-woman. Women should therefore be supported in their birth choice and should not be made to feel that their experience of childbirth is diminished if they decide to have an epidural analgesia. In addition, continuous care from a midwife in labour may reduce the need for an epidural if the woman feels safe and is given the support she needs to cope with the pain, so, one-to-one midwifery care must remain a priority for maternity services.
Research shows that epidurals are safe. There are certain circumstances in labour which may require, in some situations, the administration of epidurals including: multiple birth, prolonged labour, and the baby being in a breech position. Women with high blood pressure may also benefit from an epidural which, by relieving the pain, may make the blood pressure easier to control. Likewise, if a woman has a deep-rooted fear of childbirth, the use of pain relief will be welcome to her and may encourage her to deliver normally rather than asking for a caesarean section.
In most labour wards, mobile epidurals are now available to women. These are low-dose epidurals that maintain some muscle sensation to aid in the woman’s pushing during delivery.
There was concerned expressed in the article that the lack of pain felt by the mother during the birth would effect her relationship with the baby. However, a very painful and prolonged labour may also affect infant bonding. Women are thus advised to have direct skin-to-skin contact with their newborn immediately after birth, where possible, to encourage bonding and improve breastfeeding rates.
Notes
To view the article in the Observer article, please click here.
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