Pain control and informed consent!

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hayley2903
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Posted: Mon Mar 11, 2013 12:42 pm 
Post subject: Pain control and informed consent!
I am currently a student studying an access to midwifery.
I am carrying out a study surrounding the lack of informed consent surrounding pain control specifically during the antenatal period.
The information you submit will not be seen nor used by anyone other than myself and my tutor. If you have any questions before you complete the questionnaire or even once you have completed it, feel free to contact me at my email address. (hayley_lowe@hotmail.co.uk)
I would also like to stress you have the right to withdraw at any moment.
Thank you for your time.

Here is the link below;


www.surveymonkey.com/s/SGV8ST8
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Clairebell29
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Posted: Mon Mar 11, 2013 1:13 pm 
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All done.
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RacheynHarry
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Posted: Mon Mar 11, 2013 1:39 pm 
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Done
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MrsOz
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Posted: Mon Mar 11, 2013 3:19 pm 
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Done... & good luck with it xx
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RachN3Babies
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Posted: Mon Mar 11, 2013 4:52 pm 
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Oops did it earlier but forgot to comment on here.. X
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hayley2903
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Posted: Mon Mar 11, 2013 5:50 pm 
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Thank you for your replies so far ladies I'm getting some great feedback.
Can I just make it clear I'm looking at how women are "informed" of pain control last minute I.e during labour as I've heard way too many times of women being bullied into using pethidine (as an example) without being informed of the risks such as depressing the babys lungs. I'm guessing most women would possibly refuse such pain control if they were made aware of this when they aren't in the most excruciating pain ever!!

The questionnaire is to back up my theories or possibly even contest them!! Smile xx
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MrsOz
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Posted: Mon Mar 11, 2013 8:18 pm 
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Really? I had pethidine in early stages of labour and didn;t know that. I hadn't even heard of how pethidine was used before hand tbh. (I nearly fainted at my ante-natel class so missed parts of it when they had to check me out! Laughing Laughing )

Always knew about the epidural risks, but they were from mum, not the hosp

xx
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hayley2903
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Posted: Mon Mar 11, 2013 9:41 pm 
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Yes pethidine crosses the placenta, I sounds like you were given it at the right time though. I've heard by many who were pressured into it when they refused several times and only gave in to send away the practitioner! If given too close to pushing baby out you can become very tired during this and may lead to further intervention or you could just fall asleep during precious bonding time with baby.
If pethidine does get to baby, baby may need an injection to reverse these effects which to me just seems unecessary!! Xx
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RachN3Babies
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Posted: Mon Mar 11, 2013 11:53 pm 
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I had that problem I was given pethedine 10 minutes before I gave birth.. I dont know if it's linked but lewis needed a little bot of oxygen when he was born.. I had pethedine with Charlie with no problems though.. Also found out that codeine can affect babies respiratory system too which I didnt know iwith my last 2 pregnancies... X
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DL05
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Posted: Tue Mar 12, 2013 8:33 am 
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I was pressured into having pethidine with my first Rolling Eyes , I felt I was doing fine without anything and was walking about to cope with contractions and everything was progressing well but then was told when I decided to try the gas and air that I would have to lie down Rolling Eyes which then made me feel like I couldn't cope as well and slowed things down a bit I then got pushed into having pethidine , which made me feel drunk , just as I had to start pushing Rolling Eyes 2 hrs later I had an episiotomy and a threat of forceps if it didn't work Shocked because he kept going back between pushes
I'm certain that the pethidine affected my pushing , luckily my son was fine because it was so long from the shot to his birth but I wasn't told anything about the dangers I found out for myself later and never had it again .
I also found out later that you don't need to lie down with the gas and air Rolling Eyes if they hadn't told me that I would never have accepted the pethidine in the first place as I was fine while I could move about.
I hated the way it made me feel and I was very drowsy after the birth so when my mum had to go they stuck my son in a cot and I couldn't pick him up again on my own until later when we were back on the ward Confused
I think all forms of pain relief should be fully explained, long before labour ,during routine midwife appointments , with lots of information given out, and also natural methods of relieving pain or coping with labour even should be discussed .
Not all women feel the need to have the pain removed, some see it as part of the process,not all women even feel contractions as "painful" as such especially not the early ones ,but I think we're all sort of pre programmed by all the info out there from family and friends and even birth programmes to see it as pain and studies have shown if you expect something to be painful then you will feel the sensation as pain even if it is infact just pressure or whatever .
I wonder if sometimes midwives push pain relief on women in labour because they themselves can't imagine labouring without it Question
I know from my own births and the other 3 I've been at that often midwives will be the ones to ask , sometimes repeatedly if the woman wants pain relief even when she's not asked for it Question
Its hard watching someone else going through labour and I can understand them wanting to make it easier ,but really I think unless the woman is asking what she can have then it shouldn't be offered Question As she might not really want it but feel pressured that she's somehow being a nuisance by not having it Question
In Germany with my last they even went as far as putting something in my drip without asking me first Evil or Very Mad at least that wouldn't happen here (I hope) x
tracebumfluffwhy
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Posted: Tue Mar 12, 2013 8:43 am 
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Its bizarre so many have this issue, as with both my pg's (and they are in 2 different counties so different PCT's) there is a section in the notes where you discuss pain relief options with the mw. 1st pg I took this up as the plan was for a normal delivery (although I also learnt about all the pro's and cons in the NCT ante natal classes), second time I declined as having a planned c-section.

Does that mean noone else has this in their hand held notes, or that mw's just don't go through it on the community checkups?
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hayley2903
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Posted: Tue Mar 12, 2013 12:21 pm 
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I moved trusts several times as no one seemed to know about my bicornuate uterus even though it can be quite common but when I eventually settled around 5 months at st marys in manchester the midwife had a list of what was to happen within my appointments up until I give birth. None of this did happen, in fact everytime I brought up a birth plan I was refused a discussion about it because we weent at this point yet. I wanted a water birth and knew very well this had to be booked well in advance.
Anyway I eventually found out it was because they had decided I would have a section due to my utrus without even discussing this with me. I did eventually agree to it as Lola was breach and I wouldn't have risked any procedure to turn her with my dodgy womb however next time I have a baby I will be insisting things go my way as I was so appalled by what had happened last time.
Thank you for sharing ladies xx
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MrsOz
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Posted: Tue Mar 12, 2013 10:04 pm 
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Trace I completed this first time round, but because I clearly wasn't listening and/or missed some of the talk I ignored the pethidine section. I made it clear I really did not want an epidural... which they did a great job of encouraging me not to.

This time round I didn't get as far as having a plan, but in my 7 days of being in hospital all the MWs seemed shocked when I mentioned about my mental health... my comm MW was somewhat peeved after I came out as it was clearly written in my notes throughout on several pages including my support plan, and they just not bothered to read them. They were written so I didn't have to discuss my issues but then I had to several times over anyway.

Hayley - I was convinced that pethidine was long lasting so 12 hours later I thought I was giving birth on it, so I did not need more pain relief... dur... so I was on just gas and air.

Maybe you could have a part in your research about how people dont read your notes! lol!

xx
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Lilly777
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Posted: Wed Mar 13, 2013 1:46 pm 
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I remember the Pethadine talk at my ante-natal class, frightened the life out of me when she said that a: it can knock the mum out (tiredness wise) and b: that it can affect how the baby breathes at birth and that given too close to birth can actually result in the baby not breathing when its born Shocked Shocked

She repeated over and over that the choice was entirely the mums and that it didn't have to be taken, and when I was actually in labour I was asked about 3 times if I wanted it and was adamant I wasn't. The 1st midwife was fine with this but I'll never forget the 2nd midwife commenting that I was being silly, that I should take it if the gas and air wasnt enough (which it was) and that it would help me to get some sleep....my baby was actually born about an hour after her asking me to take the Pethadine!

I would never take it, would go straight for an epidural if I couldn't do it on gas n air next time.

xx
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BillJ
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Posted: Wed Mar 13, 2013 5:30 pm 
Post subject: Re: Pain control and informed consent!
hayley2903 wrote:
I am currently a student studying an access to midwifery.
I am carrying out a study surrounding the lack of informed consent surrounding pain control specifically during the antenatal period.


I'd like to point out that this has been allowed by AskBaby.com because:

a) Hayley used the appropriate channels and asked the AB Team prior to posting
b) It's (hopefully) useful and for a good cause
c) AB mods expressed an interest in the subject matter

All forumites, please be reassured there won't be a sudden influx of questionnaires; Hayley, good luck with your assignment!
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