The posting to my Diary entry on Anaesthetists poses an interesting question that frequently comes up in workshops for educators.

The anaesthetists mentioned in the posting may well be the ones who contacted me and asked me for the references. I replied, giving the main references that I used and asking them to be more specific - they had just asked for "my references". I have given them the references I have used, including the book “Epidurals” by Anne May (which is a textbook for anaesthetists) and have pointed out that the references are listed on this web site in the relevant sections in the Essential Parents pages. I also asked them to send me their references if they were concerned that I had missed something but I have not heard anything from them as yet.

I would be very wary of allowing them time in a prenatal program program. The selling of epidurals is insidious and subtle and these practitioners often give a very biassed account, that makes little, if any reference to the down side of epidurals. Communicating information sensitively and in a neutral fashion to groups of expectant parents in a class setting that few, if any, doctors possess. They have a vested interest to protect as their income rests on getting a good level of business, and they are also the most sued group of medical practitioners (just ahead of the obstetricians). Many times I have heard an anaesthetist tell women (and even professionals at Conferences) that “epidurals are safe for the baby”, which is not only untrue but dangerous, in terms of avoiding litigation!

I will be reviewing the content of Preparing for Birth Mothers soon, in preparation for another edition, so if there is anything they want specifically changed, they can let me know. I am aware that there are a couple of disadvantages for epidurals that I have omitted and also that I may have described spinal anaesthetics too simplistically. There will also be more on how to handle posterior labours so that an epidural can be avoided.

If they are concerned about the information you are giving, then they can always make arrangements to see women for a consultation before they go into labour to provide the information necessary for informed consent to be given, or they can prepare an accurate handout that can be given to women in advance of labour. Make sure you read any such literature and know what it says, because it can be very biassed. Literature must include the disadvantages for the baby, for example, and information on alternatives or else it will not be complete.

I am always happy to enter into discussion about anything I write. If I have made a mistake, I will correct it. If I have left something out I will try to include it when new edition is being prepared. Preparing for Birth: Mothers is not intended as a textbook with full references, it is a simple guide intended, as it states very clearly on the cover, to be “Background notes for pre-natal classes”. Educators may be asked for references and you will need to supply further details if requested. If you are not already aware of this information yourself (and you should be if you are properly prepared), ask me for the references - you will need to have them on hand for these very occasions. Posted by andrea at December 08, 2002 03:36 PM