Examining the choice behind refusal of obstetric anaesthesia
Bibliographic record
Abstract
Many women refuse an epidural during delivery, despite most women perceiving labour pain as the most excruciating event of their lifetime. This can be baffling to a physician involved in their care, but there are many historical and personal factors at play that must be taken into account. Use of obstetric anaesthesia began in 1847 and was met with controversy. In a time when childbirth physiology was poorly understood, physicians disagreed over the utility of labour pain and pain was even used as an indicator to guide delivery. Religious justification also perpetuated the reservations regarding obstetric anaesthesia. Despite initial overwhelming opposition to obstetric anaesthesia within the medical community, attitudes began to shift in favour of obstetric anaesthesia as a result of clinical observations and feminist advocacy. Obstetric anaesthesia has since been well-studied and routinely used, but historical misconceptions have endured and epidural refusal continues to linger in childbirth communities. Furthermore, there are some evidence-based concerns voiced by patients, including the risk of instrumental delivery and low risk for adverse events, which must be carefully addressed by physicians involved in patient care. In addition to concerns regarding safety of obstetric anaesthesia, pain is a subjective experience that may add meaning/fulfilment to childbirth for some patients. In conclusion, there are many historical and personal factors at play when it comes to refusal of obstetric anaesthesia, which must be understood by physicians to optimise patient care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.086 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".