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Epidural analgesia during childbirth
MAŘÍKOVÁ, Tereza
This thesis focuses on the topic of epidural analgesia during childbirth. The work consists of two main parts-theoretical and practical. The theoretical section first and foremost defines the concept of childbirth and describes all birth times. Last but not least, it is also dedicated to the role of midwife in childbirth. Another topic is obstetric pain, which is followed by the theme of pharmacological methods to labor pain relief. The issue of epidural analgesia is described in detail and divided into additional subchapters. These are devoted to the description of the procedure for administering epidural analgesia in childbirth, it's indications and contraindications, the advantages and disadvantages, the complications of epidural analgesia in childbirth and, last but not least, the role of the midwife in the care of the woman with epidural analgesia. The theoretical section concludes with a chapter on non-pharmacological methods of controlling birth pain. The first objective of the work was to determine whether women use epidural analgesia during childbirth. The second goal was to map women's satisfaction with the effects of epidural analgesia in childbirth. The third and final goal was to see if women worked better with midwives after receiving epidural analgesia. Three hypotheses have been set for the objectives. H1: First-time mothers are more likely to use epidural analgesia than multi-parents. H2: Younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). H3: Women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. The objectives were achieved by a quantitative research investigation in the form of own design questionnaires, which consisted of both open and closed questions. The assessment of the questionnaires was carried out using a statistical chi-square test which determined the significance or insignificance of the results. The first research set consisted of 205 women active on the Facebook social network. Of the total number of respondents, women in the 26-30 age range had the highest representation. The second research set included 102 midwives working in the delivery room. Midwives in the 20 to 30 age range had the highest representation of total respondents. The research investigation revealed that more than half of the respondents had used epidural analgesia during childbirth. However, only a third of women are certain that they would also use epidural analgesia for their next birth. The other two-thirds of women do not know whether they would use the epidural analgesia method or are certain that they do not want epidural analgesia in their next childbirth. We also wanted to find out whether younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). This hypothesis has not been confirmed. This was due to the low representation of the group of women over 30. We also wanted to find out whether first-time mothers use epidural analgesia more often than multi-time mothers. The result of the research showed that the largest representation of our female respondents who took advantage of epidural analgesia was just 7 % more first-time mothers. However, the difference is not statistically significant. We also wondered if women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. According to the research investigation, the vast majority of midwives think that women with epidural analgesia cooperate better during childbirth than women without epidural analgesia.
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Effect of epidural analgesia on duration of the first and second stages of labour.
Kuklová, Dagmar ; Pařízek, Antonín (advisor) ; Šimják, Patrik (referee)
Effect of Epidural Analgesia on Duration of the First and Second Stages of Labour Abstract: This bachelor's thesis deals with the topic of epidural analgesia. Nowadays, epidural analgesia is considered to be the most effective method of relieving labour pain. The thesis is both theoretical and practical. The aim of the theoretical part is to summarize knowledge about labour pain and the methods of relieving it. The thesis offers a comprehensive review of both non-pharmacological and pharmacological techniques. The method of epidural analgesia is described in more detail. The thesis describes the indications and contraindications of administering epidural analgesia. It also studies it's impact on the course of labour. The practical part of this thesis consists of results of a prospective study concerning epidural analgesia. A group of women with administered epidural analgesia during labour were compared to a group of women without administration of epidural analgesia. Then it was looked at whether this method of analgesia has any effect on the length of the first and second stages of labour. It was ascertained by statistical methods that epidural analgesia has no effect on the duration of the first and second stages of labour. Keywords: Epidural Analgesia, Labour, Childbirth, Delivery, Parturition, First...
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Mothers perception of pain during labour.
MICHÁLKOVÁ, Monika
The subject of the thesis is the labor pain and methods of pain control. The theoretical part focuses on a description of the process of childbirth and the role of midwifes at each stage of labor. This is followed by a general description of pain as well as the labor pain, methods of pain evaluation and overview of pharmacological and non-pharmacological methods used in obstetric analgesia. The research part of the work explores women's experience of pain during childbirth and methods that women prefer in relieving labor pain. For research survey was used qualitative method of data collection, using semi-structured interviews. Information obtained were divided into two main categories: "Women's experience with labor pain" and "Methods of relieving labor pain" Both categories were further subdivided into categories. Results of the research showed that women during pregnancy did not want to think about the oncoming birth pain because these ideas evoked feelings of fear and apprehension. Most women have no way to prepare for labor pain and the character and intensity of labor pain surprised almost all women. The vast majority of women accepted the offer of pharmacological labor pain reliever even though they didn't intend to originally. In addition, majority of them felt frustrated by the low effects of pharmacological methods and they attributed greater analgesic effect to non-pharmacological methods, including the presence of close person during childbirth and positive attitude of medical staff. Midwifes' help in relieving labor pain was evaluated very positively by all respondents. The results shows that the most important thing is coaching pregnant women by midwifes in preparation for labor pain and thus reduce feelings of anxiety and fear of pain during childbirth.
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Women´s opinion on bearing pain during labour by means of using pharmacological methods
JIRÁSKOVÁ, Renáta
The bachelor thesis deals with coping with pain during labour by means of pharmaceutical methods and women's opinions on these methods. The theoretical part describes labour, labour pains and non-pharmaceutical methods how to relieve labour pain and a midwife assistant's role in the care of women in travail. The research part of the bachelor thesis deals with women's antenatal knowledge about relieving pain during labour by means of pharmaceutical methods and their opinion on it. In the thesis, two main objectives were set. The first one was to find out how much women are informed about the ways how to relieve pain during labour. The second one was to find out women's opinion on using pharmaceutical methods to relieve pain during labour. In connection with these two objectives, two research questions were formulated: "How far are the women informed about using pharmaceutical methods to relieve pain during labour?" and "What is the women's opinion on using pharmaceutical methods during labour?" For the implementation of the research, the method of qualitative research investigation was used by means of intensive half-structured interviews. The content analysis was performed by means of paper and pencil method. The acquired data were categorized. Two main categories were created: Women's knowledge and Labour and pain. The research file consisted of eight women in a five months period after giving birth in hospitals in Prague. The interviews took place during May 2015 in their domestic environment. The research investigation showed that half of the respondents felt they had enough information about the methods of relieving pain and the second half felt insufficiently informed or having no information at all. Most women actively seek information on their own. They use internet the most and also get opinions from their family members and friends. Three respondents got information before their labour by hospital staff, they all got the information in a specialized course and only two of them got information in an antenatal clinic. The research showed that half of the women would appreciate to get more information about relieving pain by pharmaceutical methods already in an antenatal clinic by means of leaflets. The solution would be to educate women before the labour in antenatal clinics, during the specialized courses, where women get the information from the specialists. The questioned women showed moreless negative opinions on using pharmaceutical methods to relieve pain and most of them would rather not use them. Half of the women would use them only in case of absolutely unbearable pain. Three respondents would not use them at all. Two of them because they have good experience giving birth without using any pharmaceutical methods and one of them because she had very negative experience with intravenous systemic analgesia from her last labour. Only one respondent had a very positive opinion on using the pharmaceutical methods for relieving the pain during labour and she would go for it again. Nowadays, modern medicine offers many ways how to relieve pain during labour and it is very important to inform women and offer them this option, but the final decision is on them. The research gave answers to both questions. The research showed that half of the women were insufficiently informed, so it means they should get more information about these methods in advance. The research also showed that women would rather not use pharmaceutical methods that help relieving pain because of their previous experience or because they feel pain is a natural part of labour. This bachelor thesis can be used as a brochure to get information for midwives and students of this field. It can also be used as an educational material for pregnant women and women planning pregnancy.
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Experience of expecting mothers with spinal analgesia
VRHELOVÁ, Jitka
Obstetric analgesia has lately become a modern supplement during physiological birth as well as during births with increased risk. Spinal analgesia together with epidural analgesia represent important methods in obstetric analgesia and anesthesia during delivery. The objective and the core of my thesis is to make a survey of expecting mothers´ experience with spinal analgesia which is a less used method of obstetric analgesia than for example the epidural method. But because this method is entirely equivalent to the epidural method, it is advisable to get familiar with its adverse and positive aspects and especially with the expecting mothers´ response to this method. In the thesis I used combination of quantitative and qualitative research, with six objectives, six hypotheses and two research questions. Methods of collecting data were questionnaires and interviews. The research database consisted of women after vaginal as well as operative deliveries who had used spinal analgesia or anesthesia during delivery. Objective 1 {--} to find out the overall awareness of women about methods of obstetric analgesia was fulfilled and hypothesis 1 {--} women do not have enough information about methods of obstetric analgesia was confirmed. Objective 2 {--} to find out whether the spinal analgesia method brings expected comfort of painless birth to expecting mothers was fulfilled. Hypothesis 2 {--} spinal analgesia method brings expected comfort of painless birth to expecting mothers was confirmed as well. Objective 3 {--} to find out whether spinal analgesia has a positive effect on the course of delivery was fulfilled. Hypothesis 3 which stated that spinal analgesia method has a positive effect on course of delivery was confirmed as well. Objective 4 to find out how the spinal analgesia method influences condition of fetus during delivery was fulfilled. Hypothesis 4 {--} spinal analgesia method has a positive influence on condition of faetus during delivery was confirmed. Objective 5 was to find out side effects of spinal analgesia during delivery as well as in confinement. The objective was fulfilled and the hypothesis was confirmed as well. Objective 6 to compare postoperative condition of mothers after Caesarean section in spinal analgesia and total anesthesia was fulfilled. The hypothesis stated to objective 6 was also confirmed . Two hypotheses can be stated from the results of qualitative research which comprised two research questions. The first hypothesis claims that spinal analgesia has a positive effect on physical condition of expecting mothers during delivery. The second hypothesis claims that spinal analgesia has a positive effect on mental condition of expecting mothers. The findings from the field of obstetric analgesia and research results can be used in the nursing process not only in delivery rooms and obstetric wards but also in primary care where the pregnant woman gets into the very first contact with medical staff.
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