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The birth of a child does not have to be accompanied by suffering. There are already such methods of relieving labor pain that you and your baby will be safe. The most effective and safest anesthesia in childbirth is the epidural.
You can, of course, grit your teeth and decide to give birth like your grandmother, without pharmacological support. But what for? Who told you that suffering ennobles? In fact, acutepainstimulates your body to produce the so-called stress hormones (catecholamines), the blood vessels are also narrowed. This automatically reduces the amount of blood that flows through the uterus and placenta. What do you have to reckon with then? Firstly, the conditions of the child's existence in the uterus worsen, secondly -labor contractions , still very painful, become less effective. And delaying or even inhibiting the progress oflaboris not beneficial for the baby.
There is also the other side of the coin. When you are relaxed and calm, you have the strength and willingness to focus on the course of labor (you are not distracted by pain) and the baby comes into the world in much better shape. Faster and easier!
When is it possible to give anesthesia in childbirth?
Simply put - when it hurts and you ask for help. But in order for pain relief to begin, the obstetrician must be sure that the complaints you are complaining about are related to the onset of labor and not, for example, from the so-called predictive uterine contractions occurring one week before zero o'clock.
Most patients ask for them when the dilation of the cervix reaches 3-4 centimeters and the contractions become more painful. But this is obviously not the only right moment - this anesthesia can be used even in the second stage of labor, with a 10-centimeter dilution, provided that the head is still high and has not settled in the birth canal. The anesthesia starts working after about 10-15 minutes.
How is anesthesia administered in childbirth?
First, the anaesthesiologist anesthetized your skin (e.g. with Emla cream) at the point where the needle was inserted, thanks to which the injection does not hurt. It then inserts into the lumbar region of your back and inserts the needle into the epidural space between the two spiny processes of the 2nd, 3rd, or 4th lumbar vertebrae. He will use the needle to install a thin catheter through whichyou will be given medication. The catheter, terminated with an antibacterial filter, is attached to the back with a plaster. It acts as a reusable unilateral "stopcock" throughout labor - when you need to increase the dose, you can do so by connecting the syringe directly to the catheter, without the need to stab your back again.
You will find it most comfortable to lie on your side during the injection. Unless you are very overweight, then the anesthesiologist will probably suggest you to sit.
What will happen when the needle with anesthesia does not go where it needs to be?
The spinal cord is surrounded by a series of sheaths, one of which is the dura mater. Epidural anesthesia, as the name suggests - is done outside the tire, or more precisely above it. Could there be a situation where patients and their families fear the most, that the doctor accidentally sticks to the core? It's impossible. And not because anesthesiologists are skilled. The explanation is more trivial - with this type of anesthesia (for obstetrics), the puncture takes place in a place where the spinal cord is no longer there.
On the other hand, it happens, though extremely rare, that the dura mater is accidentally punctured. The effect of such an event may be mum's headaches, which pass without consequences after a few days. It is worth knowing that these undesirable symptoms occur only in 0.2-1.5 percent. all anesthetized women in labor.
Does anesthesia affect the course of labor?
If so, it's only to your advantage. As we have already mentioned, the relaxed and properly supplied uterine muscles work much more efficiently, which facilitates and speeds up the labor. Unfortunately, a number of untrue opinions have arisen around this issue. Time to clear them up. It is not true that the administration of anesthesia interrupts the labor or slows it down significantly. If this were the case, the anesthetic drug would be widely used as a means of preventing preterm labor. And it is not.
The statement that with properly performed anesthesia you will not feel pressure and you will not be able to give birth on your own is also untrue. Nothing like that will happen. This is confirmed by the observations made in the 1990s at the Institute of Mother and Child, when no significant prolongation of labor was found. The symptoms of labor became simply more subtle - the pain signaling contractions was replaced by a feeling of pressure and pushing. If for a moment it seems that your contractions have stopped, it only means that she is not focused enough on the signals your uterus is sending you. When you focus, you can easily sense that your body is working hard. You will start to cooperate activelywith obstetrician. And anesthesia won't stop you. The doctor calculates the doses of the anesthetic according to your weight and height. It must be chosen so as to relieve pain as much as possible, but not limit your mobility. You can walk during labor, you must be fit and active. In a word, you are able to consciously control what is happening to you from the beginning to the end.
Is the baby safe?
For a child, the anesthetic drug is absolutely safe. Do you know why? A small dose of the drug is needed to effectively numb you. So small that as it gradually crosses the placenta, it is unable to do anything that would in any way affect the condition and state of he alth in which the baby is born. So you can be calm - because of the anesthesia given to you, even for a moment the baby will not be weakened.
Physicians around the world agree that of the few methods of relieving pain in labor that have been and are still used, the epidural is the least likely to produce unwanted symptoms and is the least toxic to both mother and baby.
We often hear the opinion that the administration of this anesthesia requires the use of vacum or forceps. This is a misunderstanding. Medical statistics show that many other reasons, not related to anesthesia, encourage doctors to use tools that help a child to come into the world.
Is this anesthesia that anyone can do?
No, just an anesthesiologist. It's not just about getting stuck. The doctor must be prepared for the fact that in a completely he althy patient, without suspicion of pathology, childbirth may proceed in very different ways. Obstetricians believe that for about 20 percent of women giving birth, it is not known how it will end - with a caesarean section or other procedure…. Therefore, the anesthesiologist should be available until the end - he may have to modify the anesthesia. Thanks to the pre-installed catheter, it can administer subsequent doses of anesthetic, necessary, for example, for a caesarean section. The presence of an anaesthesiologist is also necessary "just in case", when it turns out that the woman in labor has symptoms of intolerance to the anesthetic. Only he can provide professional help quickly.
Can every woman in labor get them?
Although this method is the most versatile in obstetrics, the doctor must take into account several contraindications. First of all, it is not used in diseases of the blood coagulation system (genetic or related to the treatment of another disease) - the mother may then be at risk of hemorrhage. Contraindication are also purulent skin changes at the injection site, as well as fever in the mother,any purulent and viral infections. In this way, women who are brought to the hospital during childbirth accompanied by a haemorrhage are not anesthetized.
To avoid trouble, it is best to contact the anesthesiologist 3 weeks before the birth. The doctor will then have the opportunity to examine you, measure your blood pressure, and ask about your illnesses. It is important that during the consultation you provide him with detailed information about medications taken on a permanent basis, especially those that affect the functioning of the circulatory system.
What troubles should you reckon with?
If the anaesthesiologist had contact with the woman in labor before, he conducted a detailed interview, knows what to expect and knows how to deal with problems very well. Problems, let us add, are extremely rare.
Epidural anesthesia, in its principle of action, dilates blood vessels. This theoretically could cause a drop in blood pressure, especially if the woman stands up sharply and tries to walk. But only theoretically, because the anaesthesiologist watches over the woman in labor to prevent such a state from happening by giving the woman in a drip an appropriate amount of fluids (electrolytes). And that's enough.