Clinical Midwifery Practice

Clinical Midwifery Practice

Introduction

The purpose of this paper is to enlighten and explore midwifery practice in a holistic manner. The core objective of the paper is to describe the process of midwifery in detailed manner. In addition, the paper also explores the practice of midwifery and the trend adapted in practice during the years. The paper is aimed to construct research in order to analyse the impact of epidural analgesia on midwifery practice. Epidural Analgesia is a pain management technique in which narcotics are infused into the peridural space through an indwelling catheter. Administration may be at a continuous basal infusion rate or self-administered within programmed limits (Rowlands, Permezel, 1998, 347-362). Nonetheless, there are certain side effects of using epidural analgesia during midwifery procedure.

According to some sources, epidural analgesia is perceived to have an influence on the length of the labour. Moreover, according to certain sources, the use of epidural analgesia can create certain side effects that are harmful for the unborn child. Epidural analgesia refers to the process of injection of local analgesic, into the epidural space to block the spinal nerves. Injection is by one of two routes: caudal, through the sacrococcygeal membrane covering the sacral hiatus, or lumbar, through the intervertebral space and ligamentum flavour. Used in prolonged labour; occipitoposterior position; breech presentation; forceps delivery; to reduce hypertension in pre-eclampsia or eclampsia; multiple or preterm delivery; Caesarean section; maternal cardiac or respiratory disease; or as a result of client preference (Waldenstrom, Bergman, Vasell, 1996, 215-228).

Dangers include sudden hypotension leading to fetal hypoxia; spinal or dural tap; toxic reactions to the drug; neurological sequelae from injury or haematoma; higher risk of instrumental delivery because of poor head flexion as a result of the relaxed pelvic floor; infection. An intravenous cannula is inserted to provide a means of immediate treatment in the event of a problem and the mother should be positioned carefully to avoid hypotension. The midwife monitors maternal blood pressure and fetal heart rate frequently, especially after the first dose of bupivacaine, which is given by the anaesthetist who inserts the epidural cannula, and after each 'top up', which midwives may be trained to administer (Oertel, Lotsch, 2008, 179-194).

Aim of the Project

The aim of this project is to examine the literature in relation to epidural analgesia and how or if it effects the length of labour.

Background

There are several sources arguing about the use of epidural analgesia during midwifery practice. This paper aims to explore the influence of epidural analgesia on midwifery practice and most importantly it describes the effect of epidural analgesia on elongated labour process. The complications in labour process can cause several complications in the procedure of delivery. Nonetheless, the complications in delivery can endanger the life of mother and child. Hence, it is of prime importance to explore the effects of using epidural analgesia during labour process and its effects. The knowledge and information attained through enlightenment of this relationship between the variables selected for analysis can be useful to the midwifery practice and ...