‘Let me get the anaesthetist’

Epidural analgesia is a resource which can be extremely beneficial to women in labour and approximately 20% of women in the UK will use this method for pain relief (Department of Health (DH), 2005). An epidural is an injection of local anaesthetic into the lower spine in order to block the nerves that feed the uterus and birth canal and is considered an effective use of reducing pain in labour (Howell, 2001).

Evidence suggests that the setting in which a midwife practices will alter her model of care (Freeman, 2006). Thus midwives who practise in a more traditional role may be more confident in managing a pharmacologically pain-free mother than one who assumes more of an ‘obstetric nurse’ role where epidural analgesia may replace key midwifery skills. Madden et al (2011) has found that obstetricians had a greater preference for pharmacological pain relief whereas midwives preferred physical pain relief methods such as water and massage. However, it could be argued that the birth setting would also affect the decision making with some midwives preferring the pharmacological route also. This choice would impact the care of the mother in labour.