Nancy K. Lowe, CNM, PhD, FACNM, FAAN, is research professor in midwifery at Oregon Health and Science University in Portland, OR. She is the current president of ACC and the editor of the Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGNN).
Context and Process of Informed Consent for Pharmacologic Strategies in Labor Pain Care
Article first published online: 24 DEC 2010
2004 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 49, Issue 3, pages 250–259, May-June 2004
How to Cite
Lowe, N. K. (2004), Context and Process of Informed Consent for Pharmacologic Strategies in Labor Pain Care. Journal of Midwifery & Womens Health, 49: 250–259. doi: 10.1016/S1526-9523(04)00103-5
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- informed consent;
- nitrous oxide;
- paracervical block
The care of women experiencing labor pain often challenges midwives to provide ethical informed consent for the pharmacologic strategies common in most of America's childbearing environments. A systematic approach to this clinical dilemma begins with a conceptual understanding of the origins of labor pain stimuli, factors affecting their central nervous system processing, and the differentiation of the concepts of pain, suffering, and comfort. These concepts can be integrated into a labor pain care, rather than pain management, model for clinical practice. Because most midwives provide care for laboring women in acute care hospitals, the midwife must also understand how the standards of the Joint Commission on Accreditation of Healthcare Organizations influence the behavior of other professionals in the health care environment for laboring women and the process of informed consent. A systematic approach to informed consent for pharmacologic strategies for labor pain care strategies should begin during pregnancy and includes full, unbiased disclosure of the nature, benefits, risks, side effects, and efficacy of all methods that are available in the chosen birth setting.