Re: [ozmidwifery] Epidurals - entering the bloodstream
There are studies that suggest that babies with any form of pharmacological pain relief including and emphasising epidural pain relief cause delayed time in the first breast feed and consequently reduced longevity of breast feeding . Right now I can¹t site you to any references but they are definitely around. I¹ll confirm the ones I m aware of ASAP, Abbey Please feel free to remind me! On 12/12/06 1:42 PM, Kelly Zantey [EMAIL PROTECTED] wrote: Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can¹t find them anywhere. Best Regards, Kelly Zantey
RE: [ozmidwifery] Epidurals - entering the bloodstream
Sarah's article's are so well referenced. One of the reference's included is: 25) Fernando R, Bonello E et al. Placental and maternal plasma concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179 From here: http://onyx-ii.com/birthsong/page.cfm?epidural Kelly Zantey [EMAIL PROTECTED] wrote: Thanks Janet - a few of those links are not working. The main thing she wants is actual medical study/evidence articles - e.g. the Sarah Buckley article she says is not adequate as the comment about the drug going into the bloodstream is not referenced back to anything. she has been trying to find such evidence everywhere but it has turned up fruitful. So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http://parenting.ivillage.com/pregn...a=adid=16053332 http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? http://parenting.ivillage.com/pregn...0,,h1nz,00.html http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley http://www.acegraphics.com.au/articles/sarah02.html http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC http://birthrites.edsite.com.au/Epidural.html http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth http://www.healing-arts.org/mehl-madrona/mmepidural.htm http://www.healing-arts.org/mehl-madrona/mmepidural.htm - Original Message - From: Kelly mailto:[EMAIL PROTECTED] Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can't find them anywhere. Best Regards, Kelly Zantey -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] Epidurals - entering the bloodstream
They are very well referenced, which is why I was surprised when she challenged me on it as I knew Sarah uses lots of references (her articles are on my site) - but if you read the bit about the drugs going into the bloodstream there is no reference for that. Here's the discussion, might be easier to understand. I'm not arguing the point, but want something solid to come back to her with. http://www.bellybelly.com.au/forums/showthread.php?t=26236 -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler Sent: Tuesday, December 12, 2006 8:35 PM To: ozmidwifery@acegraphics.com.au Cc: Kelly Zantey Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream Sarah's article's are so well referenced. One of the reference's included is: 25) Fernando R, Bonello E et al. Placental and maternal plasma concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179 From here: http://onyx-ii.com/birthsong/page.cfm?epidural Kelly Zantey [EMAIL PROTECTED] wrote: Thanks Janet - a few of those links are not working. The main thing she wants is actual medical study/evidence articles - e.g. the Sarah Buckley article she says is not adequate as the comment about the drug going into the bloodstream is not referenced back to anything. she has been trying to find such evidence everywhere but it has turned up fruitful. So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http://parenting.ivillage.com/pregn...a=adid=16053332 http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? http://parenting.ivillage.com/pregn...0,,h1nz,00.html http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley http://www.acegraphics.com.au/articles/sarah02.html http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC http://birthrites.edsite.com.au/Epidural.html http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth http://www.healing-arts.org/mehl-madrona/mmepidural.htm http://www.healing-arts.org/mehl-madrona/mmepidural.htm - Original Message - From: Kelly mailto:[EMAIL PROTECTED] Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can't find them anywhere. Best Regards
RE: [ozmidwifery] Epidurals - entering the bloodstream
Kelly There was some recent research reported yesterday (I think) in the press - from Adelaide IIRC. Evidence that the fentanyl component of epidural effects babies and particularly their ability to breastfeed. Can't get the ref to hand immediately, but it is recent research. Debbie Slater Perth, WA _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kelly Zantey Sent: Tuesday, 12 December 2006 2:43 PM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can't find them anywhere. Best Regards, Kelly Zantey
Re: [ozmidwifery] Epidurals - entering the bloodstream
http://www.blackwellroyalmarsdenmanual.com/sample/mars29.htm The above link is a very in depth look at epidural drugs and their mode of action. Helen - Original Message - From: Kelly Zantey [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 8:57 PM Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream They are very well referenced, which is why I was surprised when she challenged me on it as I knew Sarah uses lots of references (her articles are on my site) - but if you read the bit about the drugs going into the bloodstream there is no reference for that. Here's the discussion, might be easier to understand. I'm not arguing the point, but want something solid to come back to her with. http://www.bellybelly.com.au/forums/showthread.php?t=26236 -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler Sent: Tuesday, December 12, 2006 8:35 PM To: ozmidwifery@acegraphics.com.au Cc: Kelly Zantey Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream Sarah's article's are so well referenced. One of the reference's included is: 25) Fernando R, Bonello E et al. Placental and maternal plasma concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179 From here: http://onyx-ii.com/birthsong/page.cfm?epidural Kelly Zantey [EMAIL PROTECTED] wrote: Thanks Janet - a few of those links are not working. The main thing she wants is actual medical study/evidence articles - e.g. the Sarah Buckley article she says is not adequate as the comment about the drug going into the bloodstream is not referenced back to anything. she has been trying to find such evidence everywhere but it has turned up fruitful. So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http://parenting.ivillage.com/pregn...a=adid=16053332 http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? http://parenting.ivillage.com/pregn...0,,h1nz,00.html http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley http://www.acegraphics.com.au/articles/sarah02.html http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC http://birthrites.edsite.com.au/Epidural.html http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth http://www.healing-arts.org/mehl-madrona/mmepidural.htm http://www.healing-arts.org/mehl-madrona/mmepidural.htm - Original Message - From: Kelly mailto:[EMAIL PROTECTED] Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello
Re: [ozmidwifery] Epidurals - entering the bloodstream
Here is a section directly dealing with epidural drugs entering the blood stream taken from the article I posted below - I haven't gone on to read the article quoted as the source tho.it does state that it is a side effect tho. Drug-related side-effects There are a number of drug-related side-effects associated with epidural opioids and local anaesthetic agents. Opioids Respiratory depression: this is due to the action of opioids on the respiratory centre. Respiratory depression may occur at two different time intervals. - Early: usually within 2 hours of the opioid injection. This may occur if high blood levels of the opioid follow absorption from the epidural space into the systemic circulation (Macintyre Ready 2001). - Original Message - From: Helen and Graham [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 10:34 PM Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream http://www.blackwellroyalmarsdenmanual.com/sample/mars29.htm The above link is a very in depth look at epidural drugs and their mode of action. Helen - Original Message - From: Kelly Zantey [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 8:57 PM Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream They are very well referenced, which is why I was surprised when she challenged me on it as I knew Sarah uses lots of references (her articles are on my site) - but if you read the bit about the drugs going into the bloodstream there is no reference for that. Here's the discussion, might be easier to understand. I'm not arguing the point, but want something solid to come back to her with. http://www.bellybelly.com.au/forums/showthread.php?t=26236 -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler Sent: Tuesday, December 12, 2006 8:35 PM To: ozmidwifery@acegraphics.com.au Cc: Kelly Zantey Subject: RE: [ozmidwifery] Epidurals - entering the bloodstream Sarah's article's are so well referenced. One of the reference's included is: 25) Fernando R, Bonello E et al. Placental and maternal plasma concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179 From here: http://onyx-ii.com/birthsong/page.cfm?epidural Kelly Zantey [EMAIL PROTECTED] wrote: Thanks Janet - a few of those links are not working. The main thing she wants is actual medical study/evidence articles - e.g. the Sarah Buckley article she says is not adequate as the comment about the drug going into the bloodstream is not referenced back to anything. she has been trying to find such evidence everywhere but it has turned up fruitful. So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http
Re: [ozmidwifery] Epidurals and Breastfeeding
Hi Can someone help? I need to resubscribe from the Christmas break and don't know how to Elaine Barbara Glare Chris Bright wrote: The message is ready to be sent with the following file or link attachments: Shortcut to: http://www.theaustr alian.news. com.au/story/ 0,20867,20905801 -2702,00. html http://www.theaustralian.news.com.au/story/0,20867,20905801-2702,00.html Epidural babies can't get grip on what's breast David King December 11, 2006 WOMEN who give birth with the aid of pain-relieving epidurals find it harder to breastfeed than those who give birth naturally, an Australian study has found. The research suggests some of the drugs used in epidurals make their way into babies' bloodstreams, subtly affecting their brains and development for weeks afterwards -- including making them less willing to breastfeed. The study by University of Sydney epidemiologist Siranda Torvaldsen adds to a growing body of knowledge that makes a link between the use of the pain-killing drug fentanyl in epidurals and problems with breastfeeding. During an epidural a catheter is inserted into the spine to allow the infusion of pain-killing drugs. These deaden the nerves that relay sensations of pain from the lower body. In a commentary on the research, published today in International Breastfeeding Journal, British scientist Sue Jordan suggests the impact of epidurals on breastfeeding should be officially classed as an adverse drug reaction. Dr Jordan, senior lecturer in applied therapeutics at Swansea University, said women given the infusions should be offered extra support to stop their infants being disadvantaged by this hidden, but far-reaching, adverse drug reaction. Dr Torvaldsen and her colleagues studied 1280 women who had given birth in the ACT, of whom 416 had an epidural. They found that 93 per cent of the women breastfed their baby in the first week, but those who had received epidurals generally had more difficulty in the days immediately after birth. By the time six months had passed, the women who had been given epidurals were twice as likely to have stopped breast-feeding, even after allowing for factors such as maternal age and education. The authors suggest the most likely cause of the problem was fentanyl, an opioid widely used as one of the components of epidurals. Such drugs pass quickly into the bloodstream and easily cross the placenta to reach the unborn baby. Dr Torvaldsen said she conducted the research after speaking to lactation consultants who had noticed that since the addition of fentanyl in epidurals they had seen more women having problems breastfeeding. She said her research added to other studies in the area, particularly a Canadian study that examined fentanyl dosages and breastfeeding outcomes. The Canadian study of 177 mothers found they were less likely to be breastfeeding if they had been given an epidural with fentanyl. Joy Heads, a lactation consultant at Sydney's Royal Hospital for Women, said similar problems had been seen when the pain-killer pethidine had been given to mothers in late stages of labour. She said some newborn babies had lost their sucking co-ordination if the mother had an intra-muscular injection of the pethidine in the last half hour of a normal delivery. Additional reporting: Sunday Times Barb Glare Counsellor, ABA Warrnambool Group Mum of Zac, 13, Dan, 11, Cassie, 8 and Guan 3 Director, ABA and Mothers Direct [EMAIL PROTECTED] mailto:[EMAIL PROTECTED] www.mothersdirect.com.au http://www.mothersdirect.com.au Have you bought your 2007 calendar yet? -- Elaine Jefford Senior Lecturer - Nursing School of Health Sciences Division of Health, Design and Science University of Canberra ACT 2601 Phone: + 61 (0) 2 6201 5380 Fax: + 61 (0) 2 6201 5128 Email: [EMAIL PROTECTED] Australian Government Higher Education Registered Provider (CRICOS): #00212K NOTICE DISCLAIMER: This email and any files transmitted with it may contain confidential or copyright material and are for the attention of the addressee only. If you have received this email in error please notify us by email reply and delete it from your system. The University of Canberra accepts no liability for any damage caused by any virus transmitted by this email.
Re: [ozmidwifery] Epidurals - entering the bloodstream
Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth http://www.healing-arts.org/mehl-madrona/mmepidural.htm - Original Message - From: Kelly Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can't find them anywhere. Best Regards, Kelly Zantey
RE: [ozmidwifery] Epidurals - entering the bloodstream
Thanks Janet - a few of those links are not working. The main thing she wants is actual medical study/evidence articles - e.g. the Sarah Buckley article she says is not adequate as the comment about the drug going into the bloodstream is not referenced back to anything. she has been trying to find such evidence everywhere but it has turned up fruitful. So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how women are told to avoid alcohol and soft cheeses in pregnancy but encouraged to imbibe powerful and dangerous drugs in labour. Drugs in labour twenty years hence. http://www.midwiferytoday.com/artic...ugsinlabour.asp http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information http://gentlebirth.org/Midwife/epirisks.html http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote: Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are none (re the hospital employed childbirth educator) See Thorp, J.A. Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. for a good review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.) one study cited an increase of 0.07 Celsius rise per hour exposure to epidural anesthesia. another reported 5% of fetuses reached cores temp in excess of 4Celsius, another found a statistically significant increase in maternal temps 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch does not always cure - the incidence depends on skill of operator July - new residents - expect a huge increase in spinals in the teaching hospitals. ) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals http://parenting.ivillage.com/pregn...a=adid=16053332 http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? http://parenting.ivillage.com/pregn...0,,h1nz,00.html http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley http://www.acegraphics.com.au/articles/sarah02.html http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC http://birthrites.edsite.com.au/Epidural.html http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth http://www.healing-arts.org/mehl-madrona/mmepidural.htm http://www.healing-arts.org/mehl-madrona/mmepidural.htm - Original Message - From: Kelly mailto:[EMAIL PROTECTED] Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves that epidural anaesthesia enters the bloodstream? Someone in my forums has said she has tried to find medical sources but can't find them anywhere. Best Regards, Kelly Zantey
Re: [ozmidwifery] epidurals and long term effects
Dear MM As a midwife from the major hospital that you refer to, I am horrified at what you describe. I did not realise that debilitating events such as foot drop and epidural headaches were being ignored. The anaesthetic department of the said hospital prides itself on its superior pain management and followup while in hospital. Have you, as the midwife of these women, put something in writing to the hospital? Services will only improve if wonderful women like you are couragous enough to stand up for the rights of women that have received less than optimal care. I extend my sympathy and regret to the women you refer to. Best wishes Rosemary
Re: [ozmidwifery] epidurals and long term effects
On 13/02/2005, at 9:06 PM, Mary Murphy wrote: which was dealt with by complimentary medicine, no interest from the hospital. I was just wondering what complimentay therapies are out there for PND would love some more info on this. Thanks Katrina (on her way to night duty.. :-) -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidurals and long term effects
You wrote:I was just wondering what complimentay therapies are out there for PND would love some more info on this The list of complementary therapies that can assist is quite long. Each individual seems to know what works for them. I personally would start with Flower Remedies, be they the English Bach Flowers, Australian Wildflowers or West Australian wildflowers. There is Homoeopathy, Reiki, Acupuncture, Acupressure, Kinesiology. As many women who have PND have had a traumatic birth experience there are also physical injuries/imbalances and these can be helped by Osteopathy, Chiropractic, Bowen, EFT (emotional freedom techniques or Tapping). This is only a sample of the therapies available. Many times they can be combined. eg Flower remedies and osteopathy or any other combination. PND is not just a result of the birth experience but has roots in the continuum of her life. I hope this helps, cheers, MM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidurals and long term effects
Thanks Mary these are awesome. Katrina On 17/02/2005, at 12:18 AM, Mary Murphy wrote: You wrote:I was just wondering what complimentay therapies are out there for PND would love some more info on this The list of complementary therapies that can assist is quite long. Each individual seems to know what works for them. I personally would start with Flower Remedies, be they the English Bach Flowers, Australian Wildflowers or West Australian wildflowers. There is Homoeopathy, Reiki, Acupuncture, Acupressure, Kinesiology. As many women who have PND have had a traumatic birth experience there are also physical injuries/imbalances and these can be helped by Osteopathy, Chiropractic, Bowen, EFT (emotional freedom techniques or Tapping). This is only a sample of the therapies available. Many times they can be combined. eg Flower remedies and osteopathy or any other combination. PND is not just a result of the birth experience but has roots in the continuum of her life. I hope this helps, cheers, MM -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidurals and long term effects
I can't help you with any references Sharon, but I have a question. what happens to the data when things DO go wrong with an epidural? I have two homebirth clients in the past couple of years who needed to be in hospital for their births, (one for PE one for APH) who had long term sequelae and who seemed not to be taken seriously by the anaesthetic dept of our major teaching hospital. The one who was induced for PE had an "epidural headache" for 11 days, despite narcotic pain relief and 3 attempts at a blood patch. She was unable to breastfeed, pick up her baby, do any mothering at all. It finally resolved after Bowen therapy to her back and neck. This was necessary for more than 6 months after the baby was born. Of course post-natal depression was also a problem which was dealt with by complimentary medicine, no interest from the hospital. The anaesthetists were not really interested in her once she left the hospital, still in severe pain and on Tramol. No follow-up. The APH (mother of 3) was left with severe "foot-drop", the story of the anaesthetists interest was the same for the above. She has long term nerve damage.Very debillitating for a young mother of 3.I think that there may be a lot of adverse outcomes that don't get reported or followed-up. MM I was wondering is there anything to suggest that epidurals administered during labour have long term effects on women. such as backpain later in life I would be interested to find this out through studies ect I have looked on the Cochrane data base but cant find anything to do with this. regards sharon
Re: [ozmidwifery] epidurals and long term effects
Hi Sharon, there is a great article with references titled 'Epidurals: real risks for mother and baby' by NZ trained GP Sarah Buckley on the birth international website available at www.acegraphics.com.au/articles/sarah02.html. Really compelling stuff on longer term morbidity for women and systemic effects on neonates. Very interesting stuff. regards, miriam --- Mary Murphy [EMAIL PROTECTED] wrote: I can't help you with any references Sharon, but I have a question. what happens to the data when things DO go wrong with an epidural? I have two homebirth clients in the past couple of years who needed to be in hospital for their births, (one for PE one for APH) who had long term sequelae and who seemed not to be taken seriously by the anaesthetic dept of our major teaching hospital. The one who was induced for PE had an epidural headache for 11 days, despite narcotic pain relief and 3 attempts at a blood patch. She was unable to breastfeed, pick up her baby, do any mothering at all. It finally resolved after Bowen therapy to her back and neck. This was necessary for more than 6 months after the baby was born. Of course post-natal depression was also a problem which was dealt with by complimentary medicine, no interest from the hospital. The anaesthetists were not really interested in her once she left the hospital, still in severe pain and on Tramol. No follow-up. The APH (mother of 3) was left with severe foot-drop, the story of the anaesthetists interest was the same for the above. She has long term nerve damage. Very debillitating for a young mother of 3. I think that there may be a lot of adverse outcomes that don't get reported or followed-up. MM I was wondering is there anything to suggest that epidurals administered during labour have long term effects on women. such as backpain later in life I would be interested to find this out through studies ect I have looked on the Cochrane data base but cant find anything to do with this. regards sharon Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidurals and long term effects
the reason im so interested is that 20 years ago I had one during my sons birth. I now suffer from backpain when I get overtired especially in the area where I had the epidural. my sister also has the same problem after her epidural which she had 4 years ago.this pain is deep muscle pain which takes your breath away and all you can do to alleviate it is go to sleep for a few hours. in my practice as a midwife I feel we should be warning women of the long term effects of epidurals say 10 to 20 years from when they have them administered but I needed the evidence to back up my claim. regards sharon - Original Message - From: Elissa and David [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 10:53 PM Subject: Re: [ozmidwifery] epidurals and long term effects You may also find the leaflets at http://www.infochoice.org/ic/ic.nsf/icx/6?OpenDocument helpful the professionals version is fully referenced . Cheers, David - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 11:07 PM Subject: Re: [ozmidwifery] epidurals and long term effects Hi Sharon, there is a great article with references titled 'Epidurals: real risks for mother and baby' by NZ trained GP Sarah Buckley on the birth international website available at www.acegraphics.com.au/articles/sarah02.html. Really compelling stuff on longer term morbidity for women and systemic effects on neonates. Very interesting stuff. regards, miriam --- Mary Murphy [EMAIL PROTECTED] wrote: I can't help you with any references Sharon, but I have a question. what happens to the data when things DO go wrong with an epidural? I have two homebirth clients in the past couple of years who needed to be in hospital for their births, (one for PE one for APH) who had long term sequelae and who seemed not to be taken seriously by the anaesthetic dept of our major teaching hospital. The one who was induced for PE had an epidural headache for 11 days, despite narcotic pain relief and 3 attempts at a blood patch. She was unable to breastfeed, pick up her baby, do any mothering at all. It finally resolved after Bowen therapy to her back and neck. This was necessary for more than 6 months after the baby was born. Of course post-natal depression was also a problem which was dealt with by complimentary medicine, no interest from the hospital. The anaesthetists were not really interested in her once she left the hospital, still in severe pain and on Tramol. No follow-up. The APH (mother of 3) was left with severe foot-drop, the story of the anaesthetists interest was the same for the above. She has long term nerve damage. Very debillitating for a young mother of 3. I think that there may be a lot of adverse outcomes that don't get reported or followed-up. MM I was wondering is there anything to suggest that epidurals administered during labour have long term effects on women. such as backpain later in life I would be interested to find this out through studies ect I have looked on the Cochrane data base but cant find anything to do with this. regards sharon Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] epidurals and long term effects
Hi Sharon An Osteopath told me that without prior knowledge she could tell if and where someone had been given an epidural and in the long term time frame you are talking of. I find that amazing and alarming. After my 4mth old had a lumbar puncture I had him treated by an Osteopath and she said she could feel the difference clearly in the areas below and above the sight. Hopefully for him treating it early will be enough. It might be worth contacting the Osteopathic association to see if they have any information that you can use. They have a website or try the phonebook. Cheers Megan -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of shaz42 Sent: Monday, 14 February 2005 8:16 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] epidurals and long term effects the reason im so interested is that 20 years ago I had one during my sons birth. I now suffer from backpain when I get overtired especially in the area where I had the epidural. my sister also has the same problem after her epidural which she had 4 years ago.this pain is deep muscle pain which takes your breath away and all you can do to alleviate it is go to sleep for a few hours. in my practice as a midwife I feel we should be warning women of the long term effects of epidurals say 10 to 20 years from when they have them administered but I needed the evidence to back up my claim. regards sharon - Original Message - From: Elissa and David [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 10:53 PM Subject: Re: [ozmidwifery] epidurals and long term effects You may also find the leaflets at http://www.infochoice.org/ic/ic.nsf/icx/6?OpenDocument helpful the professionals version is fully referenced . Cheers, David - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 11:07 PM Subject: Re: [ozmidwifery] epidurals and long term effects Hi Sharon, there is a great article with references titled 'Epidurals: real risks for mother and baby' by NZ trained GP Sarah Buckley on the birth international website available at www.acegraphics.com.au/articles/sarah02.html. Really compelling stuff on longer term morbidity for women and systemic effects on neonates. Very interesting stuff. regards, miriam --- Mary Murphy [EMAIL PROTECTED] wrote: I can't help you with any references Sharon, but I have a question. what happens to the data when things DO go wrong with an epidural? I have two homebirth clients in the past couple of years who needed to be in hospital for their births, (one for PE one for APH) who had long term sequelae and who seemed not to be taken seriously by the anaesthetic dept of our major teaching hospital. The one who was induced for PE had an epidural headache for 11 days, despite narcotic pain relief and 3 attempts at a blood patch. She was unable to breastfeed, pick up her baby, do any mothering at all. It finally resolved after Bowen therapy to her back and neck. This was necessary for more than 6 months after the baby was born. Of course post-natal depression was also a problem which was dealt with by complimentary medicine, no interest from the hospital. The anaesthetists were not really interested in her once she left the hospital, still in severe pain and on Tramol. No follow-up. The APH (mother of 3) was left with severe foot-drop, the story of the anaesthetists interest was the same for the above. She has long term nerve damage. Very debillitating for a young mother of 3. I think that there may be a lot of adverse outcomes that don't get reported or followed-up. MM I was wondering is there anything to suggest that epidurals administered during labour have long term effects on women. such as backpain later in life I would be interested to find this out through studies ect I have looked on the Cochrane data base but cant find anything to do with this. regards sharon Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] epidurals and long term effects
thanks for that I will look on the website. not enough information is given to women when an epidural is offered. thankfully I had my second child with no pain relief whatsoever which was a more natural and positive experience for me. - Original Message - From: Megan and Larry [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, February 14, 2005 10:53 AM Subject: RE: [ozmidwifery] epidurals and long term effects Hi Sharon An Osteopath told me that without prior knowledge she could tell if and where someone had been given an epidural and in the long term time frame you are talking of. I find that amazing and alarming. After my 4mth old had a lumbar puncture I had him treated by an Osteopath and she said she could feel the difference clearly in the areas below and above the sight. Hopefully for him treating it early will be enough. It might be worth contacting the Osteopathic association to see if they have any information that you can use. They have a website or try the phonebook. Cheers Megan -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of shaz42 Sent: Monday, 14 February 2005 8:16 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] epidurals and long term effects the reason im so interested is that 20 years ago I had one during my sons birth. I now suffer from backpain when I get overtired especially in the area where I had the epidural. my sister also has the same problem after her epidural which she had 4 years ago.this pain is deep muscle pain which takes your breath away and all you can do to alleviate it is go to sleep for a few hours. in my practice as a midwife I feel we should be warning women of the long term effects of epidurals say 10 to 20 years from when they have them administered but I needed the evidence to back up my claim. regards sharon - Original Message - From: Elissa and David [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 10:53 PM Subject: Re: [ozmidwifery] epidurals and long term effects You may also find the leaflets at http://www.infochoice.org/ic/ic.nsf/icx/6?OpenDocument helpful the professionals version is fully referenced . Cheers, David - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Sunday, February 13, 2005 11:07 PM Subject: Re: [ozmidwifery] epidurals and long term effects Hi Sharon, there is a great article with references titled 'Epidurals: real risks for mother and baby' by NZ trained GP Sarah Buckley on the birth international website available at www.acegraphics.com.au/articles/sarah02.html. Really compelling stuff on longer term morbidity for women and systemic effects on neonates. Very interesting stuff. regards, miriam --- Mary Murphy [EMAIL PROTECTED] wrote: I can't help you with any references Sharon, but I have a question. what happens to the data when things DO go wrong with an epidural? I have two homebirth clients in the past couple of years who needed to be in hospital for their births, (one for PE one for APH) who had long term sequelae and who seemed not to be taken seriously by the anaesthetic dept of our major teaching hospital. The one who was induced for PE had an epidural headache for 11 days, despite narcotic pain relief and 3 attempts at a blood patch. She was unable to breastfeed, pick up her baby, do any mothering at all. It finally resolved after Bowen therapy to her back and neck. This was necessary for more than 6 months after the baby was born. Of course post-natal depression was also a problem which was dealt with by complimentary medicine, no interest from the hospital. The anaesthetists were not really interested in her once she left the hospital, still in severe pain and on Tramol. No follow-up. The APH (mother of 3) was left with severe foot-drop, the story of the anaesthetists interest was the same for the above. She has long term nerve damage. Very debillitating for a young mother of 3. I think that there may be a lot of adverse outcomes that don't get reported or followed-up. MM I was wondering is there anything to suggest that epidurals administered during labour have long term effects on women. such as backpain later in life I would be interested to find this out through studies ect I have looked on the Cochrane data base but cant find anything to do with this. regards sharon Find local movie times and trailers on Yahoo! Movies. http://au.movies.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list
Re: [ozmidwifery] epidurals and long term effects
Hi Sharon, One of the problems with epidurals (especially those done years ago when full blocks were popular) is that it is very easy to wrench the joints and ligaments, especially if the woman is moved in any way while the epidural is in place. Without the protection of the musculature, the joints are vulnerable, and midwives know that if her legs need to be lifted (for example, into stirrups in preparation for forceps) then both legs should be lifted together, to avoid the lower vertebrae, especially their junction with the spine, being jarred. The back pain that may result after the birth may not be because of the epidural itself, but rather what happened to the woman's body while the epidural was in effect. A study by Macarthur that investigated the long term results of epidurals in 11,701 women in Birmingham found that backache was more common for women who had epidurals (18.9% compared to 10.5%), more frequent headaches ( 4.6% compared to 2.9%) more neckache (2.4% compared to 1.6%) and tingling in the hands or fingers (3.0% compared to 2.2%). The results could not be correlated to social or obstetric factors. 26 women had numbness or tingling in the lower back, buttocks and leg, of whom 23 had epidurals. Of 34 women with spinal headache, nine reported long term headaches. This is not a randomised controlled trial but is nevertheless one of the few studies that have investigated long term problems. Important to note that RCTs of epidurals are very unlikely to occur, as the anaesthetists have taken the stand that to perform an RCT would require that women in the control group would be denied access to this technique and to do this would be unethical. Perhaps this is one reason why they are so uninterested in the problems women report - they can claim that there is no evidence to support their claims that the problem was linked to the epidural. The reason there is no evidence is because they are not doing any studies! Macarthur C, Lewis M, Knox E. Investigation of long term problems after obstetric epidural anaesthesia. BMJ 1992; 304:(1279-82. Regards Andrea t 08:45 AM 14/02/2005, you wrote: the reason im so interested is that 20 years ago I had one during my sons birth. I now suffer from backpain when I get overtired especially in the area where I had the epidural. my sister also has the same problem after her epidural which she had 4 years ago.this pain is deep muscle pain which takes your breath away and all you can do to alleviate it is go to sleep for a few hours. in my practice as a midwife I feel we should be warning women of the long term effects of epidurals say 10 to 20 years from when they have them administered but I needed the evidence to back up my claim. regards sharon - Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Epidurals
Hey listers, I was wondering if I could get some clarification of the phrase 'Term PROM' is this not a contradiction.??? Premature Rupture of Membranes ? at Term Or is the P (Premature) relating to prior to onset of contractions or active labour?? Thanking you in advance. Rita Deliverywoman[EMAIL PROTECTED] wrote: Hi Everyone, Out of interest to you all I work in a large tertiary hospital where 2-4 inductions/day are booked, mainly due to post-dates ( Term + 10 -14/7 ), but also obstetric complications of maternal and fetal origin, and Term PROM Find local movie times and trailers on Yahoo! Movies.
Re: [ozmidwifery] Epidurals
It would be very interesting to have some input from Sarah Buckley in regard to the effect on the womans own hormones and whether induction would be more successful if no "cold" epidural. MM
Re: [ozmidwifery] Epidurals
Hi Everyone, Out of interest to you all I work in a large tertiary hospital where 2-4 inductions/day are booked, mainly due to post-dates ( Term + 10 -14/7 ), but also obstetric complications of maternal and fetal origin, and Term PROM. Both Prostins and ARM are used based on the Bishops score. After ARM, assuming no complications, women are given 1 - 4 hours to establish significant contractions themselves to avoid a Syntocinon drip, or to Iabour within 24 hours in the case of Term PROM. I consequently see a large number of Epidurals used for pain relief, and also to lower blood pressure in pre-eclamptic women. Whilst we, as midwives, may not all agree with these protocols, it is our duty of care to ensure our patients are fully informed of their individual options and supported in their choices. I concede it is difficult to do this effectively when I meet them for the first time in Birth Suite, especially with no antenatal education. It would be nice for us if all women were pro-active in determining their birth plan in advance in collaboration with their primary care-giver, be it GP, Obstetrician , or midwife, but sadly as we all know this is not the case with many women arriving at hospital for their baby's birth with no knowledge of the birth process, let alone knowing the effects of analgesia on bonding or breastfeeding. While it isn't my intention to debate here the pitfalls of a pregnant woman's access to information on antenatal education in the public health system, we know lack of education can contribute to the high number of inductions and epidurals we see, eh! Having said that as Monica mentioned, not every woman who consequently seeks an Epidural is suitable for one, like her patient with the deteriorating COAGs. Recently I cared for a woman with the opposite problem, i.e. Thrombocythaemia, where the anaesthetist feared haematoma formation in the epidural space, and so a PCA was recommended for pain relief, if required. I've also seen a PCA used on a morbidly obese woman to control her pain and thus lower her blood pressure, when the anaesthetic registrar and consultant both failed in their many attempts to site a working epidural. While not the analgesic of choice in most cases, I hope, I can see where a PCA has a place. Cheers, Gaye.
RE: [ozmidwifery] Epidurals
Title: Message I have assisted a woman who had ITP with coags 40. Dr's were very reluctant to use an epidural and instead used a fentanyl PCA. This was very effective, she wasn't too drugged and as fentanyl has a very short half life seemed to work well with her, minmal effect on the infant at birth. Problem I had was with a senior midwife who got her pushing way too early when I was at lunch. No urge to push 'but your fully dilated love hold your breath and push'. All I could imagine was those very fragile alveoli/capillary vessels in the lungs rupturing and I would have pink frothy sputum or the cerebral blood vessel bursting causing a major cerebral event. I needed a good debrief after that one! Cheers Barb -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of mhSent: Friday, 5 November 2004 1:19 PMTo: [EMAIL PROTECTED]Subject: Re: [ozmidwifery] Epidurals From a different perspective, we have used a PCA (Fentanyl) in labour when the mother has requested more painrelief than IM Morphine and an epidural is contraindicated, eg this week- fetal death in utero at 26 weeks, mother septic with bordeline then deteriorating coags. Labour induced with Cervagem over 36 hrs then further 24 hrs of Syntocinon. Mother could not cope with pain and circumstances any longer. This situation is infrequent. I have never seen them used with a viable baby. Monica - Original Message - From: sally To: [EMAIL PROTECTED] Sent: Thursday, November 04, 2004 9:32 PM Subject: Re: [ozmidwifery] Epidurals My Goodness!!! A PCA in labour, that's absolutely appalling. Sally - Original Message - From: Michelle Windsor To: [EMAIL PROTECTED] Sent: Thursday, November 04, 2004 9:29 PM Subject: [ozmidwifery] Epidurals While on the subject of epidurals I read an article recently about a study involving ewes which had epidurals during their labour. They wouldn't mother their young. A new term I learnt this year while doing a short contract in a private hospitalwas the "cold epidural" - the epidural you have put in prior to the start of your induction! Not sure how common this is in other places. Of course if there is any problem getting the epidural in you can always have a PCA of morphine. You can imagine the results of that - one very "stoned" mother totally uninterested in her narcotised baby. Sad but true. Cheers Michelle Find local movie times and trailers on Yahoo! Movies. ---Incoming mail is certified Virus Free.Checked by AVG anti-virus system (http://www.grisoft.com).Version: 6.0.784 / Virus Database: 530 - Release Date: 10/27/2004
Re: [ozmidwifery] Epidurals
It would be nice for us if all women were pro-active in determining their birth plan in advance in collaboration with their primary care-giver, be it GP, Obstetrician , or midwife, but sadly as we all know this is not the case with many women arriving at hospital for their baby's birth with no knowledge of the birth process, let alone knowing the effects of analgesia on bonding or breastfeeding. I know soo many women that have their birth plan fully researched and written out, discussed with care givers and most where caregivers have agreed, they come into the "birthing place" wherever it may be, give out multiple copies and noone takes any notice of them what-so-ever. If these "professionals" have made it so women believe they need them to birth, then these "professionals" need to educate, inform and share knowledge We live in a society of broken families, broken birth lines, mothers who were not even awake for the birth and we were taken from our mothers for hours..how will women learn and become proactive. Yes there are women that take the initiative and become proactive but it takes alot of guts, strength and frustration. It is not as easy as, "well I understand the birthing process and I have a great birth plan and I want a natural birth etc", women come up against fight after fight during pregnancy, labour and postnatally. From the whole, "how about you wee on this stick so I can know that you are REALLY pregnant" to, "we should talk about induction for your "late" baby" to "no really it's routine, you do need this shot of syntocinon" or, " oh! you wanted me to leave the cord pulsating...we couldn't do that, it is against protocol!" The uneducated "knowledge" has come from the people women are meant to trust. It makes me mad when I read or hear comments as above. If a woman has spent 8 months going on her monthly, then fortnightly, then weekly, maybe daily visits to her "professional" care giver, then she should know and understand the knowledge of the birth process. It is not the lack of knowledge on the woman's part that is the problem, it is the lack of educated knowledge shared that is the problem. Love Abby
Re: [ozmidwifery] Epidurals
From a different perspective, we have used a PCA (Fentanyl) in labour when the mother has requested more painrelief than IM Morphine and an epidural is contraindicated, eg this week- fetal death in utero at 26 weeks, mother septic with bordeline then deteriorating coags. Labour induced with Cervagem over 36 hrs then further 24 hrs of Syntocinon. Mother could not cope with pain and circumstances any longer. This situation is infrequent. I have never seen them used with a viable baby. Monica - Original Message - From: sally To: [EMAIL PROTECTED] Sent: Thursday, November 04, 2004 9:32 PM Subject: Re: [ozmidwifery] Epidurals My Goodness!!! A PCA in labour, that's absolutely appalling. Sally - Original Message - From: Michelle Windsor To: [EMAIL PROTECTED] Sent: Thursday, November 04, 2004 9:29 PM Subject: [ozmidwifery] Epidurals While on the subject of epidurals I read an article recently about a study involving ewes which had epidurals during their labour. They wouldn't mother their young. A new term I learnt this year while doing a short contract in a private hospitalwas the "cold epidural" - the epidural you have put in prior to the start of your induction! Not sure how common this is in other places. Of course if there is any problem getting the epidural in you can always have a PCA of morphine. You can imagine the results of that - one very "stoned" mother totally uninterested in her narcotised baby. Sad but true. Cheers Michelle Find local movie times and trailers on Yahoo! Movies.
Re: [ozmidwifery] epidurals and BF rates...
In a message dated 24/03/03 10:27:58 AM AUS Eastern Daylight Time, [EMAIL PROTECTED] writes: Dear Tina I also feel it is significant that the problems were highest for the primip many of who may not have another baby or carry the negative experience into the subsequent pregnancy! In this age of 1.3 babies per capita Denise Ditto Denise, Regards Tina.
Re: [ozmidwifery] epidurals and BF rates...
Dear Tina I also feel it is significant that the problems were highest for the primip many of who may not have another baby or carry the negative experience into the subsequent pregnancy! In this age of 1.3 babies per capita Denise PS well done on being on the program of the Next NSW MA State conference - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, March 23, 2003 4:37 AM Subject: [ozmidwifery] epidurals and BF rates... Hi alldoing the rounds of the journals tonight...found this interesting snippet...Yours in reforming midwiferyTina Pettigrew.B Mid Student ACU Melbhttp://groups.yahoo.com/group/BMidStudentCollective/" As we trust the flowers to open to new life - So we can trust birth"Harriette Hartigan.--- Effect of Labor Epidural Anesthesia on Breast-Feeding of Healthy Full-Term Newborns Delivered Vaginallyfrom Journal of the American Board of Family PracticePosted 03/05/2003Dennis J. Baumgarder, MD, Patricia Muehl, RN, MSN, Mary Fischer, MS, Bridget Pribbenowhttp://www.medscape.com/viewarticle/449424Abstract and IntroductionAbstractBackground: Epidural anesthesia is commonly administered to laboring women. Some studies have suggested that epidural anesthesia might inhibit breast-feeding. This study explores the association between labor epidural anesthesia and early breast-feeding success.Methods: Standardized records of mother-baby dyads representing 115 consecutive healthy, full-term, breast-feeding newborns delivered vaginally of mothers receiving epidural anesthesia were analyzed and compared with 116 newborns not exposed to maternal epidural anesthesia. Primary outcome was two successful breast-feeding encounters by 24 hours of age, as defined by a LATCH breast-feeding assessment score of 7 or more of 10 and a latch score of 2/2. Means were compared with the Kruskal-Wallis test. Categorical data were compared using the Mantel-Haenszel chi-square test. Stratified analysis of potentially confounding variables was performed using Mantel-Haenszel weighted odd ratios (OR) and chi-square for evaluation of interaction.Results: Both epidural and nonepidural anesthesia groups were similar except maternal nulliparity was more common in the epidural anesthesia group. Two successful breast-feedings within 24 hours of age were achieved by 69.6% of mother-baby units that had had epidural anesthesia compared with 81.0% of mother-baby units that had not (odds ratio [OR] 0.53, P = .04). These relations remained after stratification (weighted odds ratios in parenthesis) based on maternal age (0.52), parity (0.58), narcotics use in labor (0.49), and first breast-feeding within 1 hour (0.49). Babies of mothers who had had epidural anesthesia were significantly more likely to receive a bottle supplement while hospitalized (OR 2.63; P .001) despite mothers exposed to epidural anesthesia showing a trend toward being more likely to attempt breast-feeding in the 1 hour (OR 1.66; P = .06). Mothers who had epidural anesthesia and who did not breast-feed within 1 hour were at high risk for having their babies receive bottle supplementation (OR 6.27).Conclusions: Labor epidural anesthesia had a negative impact on breast-feeding in the first 24 hours of life even though it did not inhibit the percentage of breast-feeding attempts in the first hour. Further studies are needed to elucidate the exact nature of this association.
