Epidurals for childbirth: Edited by A. May Oxford Medical Publications, Oxford, p. 203; indexed; illustrated. £14:95. ISBN Hbk 019 262439 3; ISBN Pbk 019 262438 5

Abstract

This extremely comprehensive book is aimed primarily at junior anaesthetists, midwives and other personnel involved in the care of pregnant and labouring women. It fills the gap left between clinical teaching and standard text books and current papers by its more basic, practical approach, with clearly written background information sitting alongside more detailed, technical guidelines. The more standard chapters on anatomy, physiology and indications for epidural analgesia are clearly written and easy to follow with the help of good illustrations. Particularly good are the discussions on more controversial issues such as the use of saline or air to demonstrate loss of resistance, and the sitting or the lying position used for siting an epidural. Also the recipe-style directions on how to perform a blood patch and on topping up an epidural should prove very useful to the learning anaesthetist. With the recent changes in midwifery practice and the evolution of obstetric anaesthesia as a specialty in its own right women are more informed about childbirth and methods of pain relief than ever before. Anne May includes an excellent chapter ‘What do we tell the patient?’ which should be read by midwives, anaesthetists and obstetricians alike. Many of the questions commonly asked by women in the antenatal period and during labour are answered clearly and conscisely with a few useful figures supplied to quantify some of the risks. The role of the obstetric anaesthetist has evolved enormously in many obstetric departments over recent years and the chapter ‘Setting up and running an epidural service’ makes for very informative reading for any one contemplating this task. It is unfortunate that in order to keep the text as simple and as undaunting as possible to all readers few references are given except in the form of a ‘further reading’ list at the end of each chapter. However, this is a small price to pay for what I feel is an excellent book. It deserves to be read by all midwifery and medical attendants involved in the antenatal and peripartum care of pregnant women.