Table 3.35, Main resource requirements for epidural and opioid analgesia - WHO recommendations: Intrapartum care for a positive childbirth experience

Resource	Description
Staff	▪ Epidural analgesia; an anaesthetist or other specialized health care professional with training in epidural insertion and management; other trained staff, e.g. nurse trained in monitoring women with epidural analgesia ▪ Opioid; a physician is usually needed to prescribe opioids (this varies between countries and settings); however, other staff, such as a midwife or nurse, can administer opioids
Training	▪ Epidural analgesia; specialist medical training is required ▪ Opioid; fairly easy to administer
Supplies	▪ Epidural analgesia; infusion solution, sterile pack (including gloves, gown, hat, mask, sterile drapes), epidural insertion kit, skin cleaning solution, intravenous catheter, appropriate medicines for resuscitation, oxygen ▪ Opioid; medicine (e.g. pethidine), needle, syringe, intravenous catheter (optional), skin cleaning solution, oxygen, appropriate medicines for resuscitation
Equipment and infrastructure	▪ Epidural analgesia; drip stand, infusion pump, oxygen and full resuscitation equipment ▪ Opioid; oxygen and full resuscitation equipment
Time	▪ Staff time to administer and monitor epidural analgesia is substantially longer than the time to administer and monitor opioid use
Supervision and monitoring	▪ Both epidural analgesia and opioids need supervision and monitoring ▪ Complications associated with epidural usually require specialist supervision and management by an anaesthetist and obstetrician (if assisted instrumental birth is required)

WHO recommendations: Intrapartum care for a positive childbirth experience.

Geneva: World Health Organization; 2018.

Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing.

Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user.

Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”.

Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Table 3.35Main resource requirements for epidural and opioid analgesia