ABSTRACT
No disponible
Subject(s)
Adult , Female , Humans , Pregnancy , Access to Information , Drug Information Services/standards , Health Communication/methods , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Analgesia, Obstetrical/instrumentation , Analgesia, Obstetrical/methods , Analgesia, Obstetrical , /methods , Analgesia, Obstetrical/ethics , Analgesia, Obstetrical/standards , Analgesia, Obstetrical/trends , Pregnancy Trimester, Third , Pregnancy Trimester, Third/physiology , Surveys and QuestionnairesABSTRACT
Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.
Subject(s)
Advance Directives , Analgesia, Obstetrical/ethics , Choice Behavior , Informed Consent , Labor Pain/drug therapy , Labor, Obstetric , Mental Competency , Parturition , Personal Autonomy , Vaginal Birth after Cesarean/ethics , Anesthesia, Epidural/ethics , Beneficence , Contracts , Decision Making , Female , Humans , Informed Consent/ethics , Informed Consent/psychology , Labor Pain/psychology , Labor, Obstetric/psychology , Metaphor , Parturition/psychology , PregnancyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Analgesia, Epidural/trends , Analgesia, Epidural , Labor Pain/drug therapy , Analgesia, Obstetrical/instrumentation , Analgesia, Obstetrical/methods , Parturition , Analgesia, Obstetrical/ethics , Analgesia, Obstetrical/statistics & numerical data , Analgesia, Obstetrical/trendsABSTRACT
Anaesthetists are legally obliged to obtain informed consent before performing regional analgesia in labour. A postal survey of consultant-led UK anaesthetic units was performed in September 2007 to assess practice regarding obtaining informed consent before inserting an epidural, and documentation of the risks discussed. The response rate was 72% (161/223). There was great variation between units regarding which risks women were informed about and the likely incidence of that risk. One hundred and twenty-three respondents out of 157 providing an epidural service (78%) supported a national standardised information card endorsed by the Obstetric Anaesthetists' Association, with all the benefits and risks stated, to be shown to all women before consenting to an epidural in labour.
Subject(s)
Analgesia, Epidural/ethics , Analgesia, Obstetrical/ethics , Informed Consent/statistics & numerical data , Analgesia, Epidural/adverse effects , Analgesia, Obstetrical/adverse effects , Female , Health Care Surveys , Humans , Labor, Obstetric , Patient Education as Topic , Pregnancy , Professional Practice/statistics & numerical data , Risk Assessment/methods , United KingdomABSTRACT
The decision-making process in childbearing women regarding birth preferences raises ethical dilemmas related to caring for women during labor and birth. Giving birth is a powerful, life-changing event that leaves a lasting impact on the childbearing woman. The birth experience may be perceived positively or negatively or with feelings of ambivalence. This descriptive qualitative study asked what factors influence a woman's change in her stated birth preference from an unmedicated birth to a medicated birth. A purposive convenience sample of 33 primiparous and multiparous childbearing women who had changed their stated birth preference for pain management during labor participated in interviews conducted within a month of giving birth. Themes included wanting an unmedicated birth; changing to a medicated birth; feeling disappointed, ambivalent, or satisfied; and reflecting on the change. Changing birth preferences is a result of many complex factors, including the influence of professional support by nurses. Ethical principles such as autonomy, veracity, beneficence, informed consent, standard of best interest, and obligations should be applied when caring for laboring women, framed by the ethics of caring.
Subject(s)
Analgesia, Obstetrical/psychology , Decision Making/ethics , Ethics, Nursing , Labor, Obstetric/psychology , Mothers/psychology , Neonatal Nursing/ethics , Patient Participation/psychology , Adult , Analgesia, Obstetrical/ethics , Analgesia, Obstetrical/nursing , Choice Behavior/ethics , Decision Support Techniques , Empathy , Female , Humans , Informed Consent/ethics , Informed Consent/psychology , Models, Psychological , Mothers/education , Neonatal Nursing/organization & administration , Nurse's Role/psychology , Nurse-Patient Relations/ethics , Nursing Methodology Research , Patient Advocacy/ethics , Patient Advocacy/psychology , Patient Education as Topic/ethics , Pregnancy , Principle-Based Ethics , Qualitative Research , Social Support , Surveys and Questionnaires , United StatesSubject(s)
Analgesia, Obstetrical/nursing , Informed Consent , Labor Pain/nursing , Midwifery/standards , Analgesia, Obstetrical/ethics , Analgesia, Obstetrical/standards , Analgesics/therapeutic use , Ethics, Nursing , Female , Humans , Informed Consent/legislation & jurisprudence , Midwifery/ethics , Pregnancy , United StatesABSTRACT
The care of women experiencing labor pain often challenges midwives to provide ethical informed consent for the pharmacologic strategies common in most of America's childbearing environments. A systematic approach to this clinical dilemma begins with a conceptual understanding of the origins of labor pain stimuli, factors affecting their central nervous system processing, and the differentiation of the concepts of pain, suffering, and comfort. These concepts can be integrated into a labor pain care, rather than pain management, model for clinical practice. Because most midwives provide care for laboring women in acute care hospitals, the midwife must also understand how the standards of the Joint Commission on Accreditation of Healthcare Organizations influence the behavior of other professionals in the health care environment for laboring women and the process of informed consent. A systematic approach to informed consent for pharmacologic strategies for labor pain care strategies should begin during pregnancy and includes full, unbiased disclosure of the nature, benefits, risks, side effects, and efficacy of all methods that are available in the chosen birth setting.
