Pain relief during childbirth. Anticonvulsant medications during childbirth. Non-drug methods of labor pain relief

The issue of pain relief during childbirth is always relevant for expectant mothers and is decided each time on an individual basis, depending on many factors.

As the due date approaches, every expectant mother, one way or another, thinks about the upcoming difficulties that are associated with the birth of a child. We are talking about severe pain that invariably accompanies the birth process. Of course, each person is individual, and for some women, pain during birth is a completely tolerable, albeit unpleasant sensation, while for others it is a source of incredible torment.

It has been proven that in most cases, a woman experiencing severe pain for a long time may, at the decisive moment, simply not be ready to give birth to a child. naturally, the body is exhausted, and the woman in labor simply does not have the strength to push. To prevent this from happening, painkillers are used during childbirth.

Pain relief during childbirth can be used for a number of other reasons:

As we have already said, the task of pain relief is the woman’s comfort and her readiness for the birth of a child. A quarter of women in labor pain threshold so low that, experiencing pain during contractions, some simply experience a feeling of panic, may perform inappropriate actions, and do not listen to the doctor’s instructions. In this case, the painkiller used during childbirth is designed to eliminate the woman's restless behavior.
Painful sensations are also relieved if the baby is expected to be too large, or twins, and also during long, or, conversely, premature or “rapid” labor.
It happens that during the birth process an emergency is required surgical intervention, for example, applying forceps, or removing the placenta. In such cases, special drugs are also used, usually intravenous.
The use of an anesthetic is considered effective if there is a risk of fetal hypoxia, or in expectant mother weak labor activity. Here the effect is directed slightly in the other direction, and not towards removing pain. In case of hypoxia, for example, the use of such drugs reduces the risk of oxygen starvation in the baby.

Regarding the risks associated with the use of drugs that relieve discomfort, then, contrary to the popular belief that this can have a detrimental effect on the child’s health, doctors believe otherwise. As we have already said, the issue is resolved individually each time, and the effect is, of course, primarily aimed at bringing benefit and not harm. Of course, each drug has its own list of contraindications, but we will talk about this a little lower when we look at what exist. modern methods pain relief during childbirth.

Types of pain relief during childbirth

Pain relief techniques during childbirth can be completely different, from the use medicines, to techniques that explain how to relieve pain during childbirth yourself. Let's start, perhaps, with pain relief during childbirth. modern conditions, that is, those methods the main principle of which is one or another introduction of medications into the body.

Drug pain relief during childbirth

Medicines designed to reduce pain during contractions may enter the body in different ways, from inhalations and compresses, to their intramuscular and intravenous administration. Let's take a closer look at how and how labor pain is relieved.

Inhalations

For such labor pain relief, a mixture of nitrous oxide and oxygen is used. This combination is quite effective and is used during dilatation of the cervix. The description of this method, by the way, gives an answer to the question “is labor anesthetized in the first period?”, which includes the time of dilatation. The advantage of this method is that the woman herself determines the degree of pain and takes a breath as needed.

Intravenous anesthesia

What is injected into a vein during childbirth for pain relief? Most often, these drugs, designed to provide pain relief during childbirth, are various analgesics. By the way, they enter the body not only, but also intramuscularly and with the help of special compresses. This method of easing the prenatal period is aimed at allowing a woman to fully rest between contractions and gain strength that will be needed during pushing.

Sometimes a doctor, when deciding what kind of pain relief to use during childbirth, chooses a drug such as promedol. Although promedol is a narcotic drug, it has been proven that its one-time use will not harm either the mother or the child. This drug is not used on last stage labor activity, otherwise this method may affect the baby’s respiratory activity; in other words, it will be difficult for him to take his first breath.

Often, and especially during the birth of the first baby, a situation arises that labor is significantly delayed. In such cases, to give the expectant mother a rest, doctors put her to sleep.

Epidural anesthesia

Here, labor pain medication is injected into the back (spine) using a catheter. This method provides almost complete relief from pain symptoms, but you must remember that along with the pain, the ability to move independently for some time may also disappear. This depends on the dosage of the drug administered; sometimes a woman can fully stand on her feet. The downside is the fact that while using this method, the woman in labor loses the ability to fully push. Therefore, shortly before the start of pushing, the administration of the medicine is stopped.

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Lecture No. 16 (04/15/14)

Pain relief for childbirth: modern principles and methods.

Pain relief for childbirth – a set of measures aimed at the prevention and treatment of disorders of uterine contractility, correction of the threatening condition of the intrauterine fetus and elimination of severe discomfort in women in labor.

Excessive labor pain can disrupt normal labor birth act, contribute to fatigue during childbirth, the development of weakness and incoordination of labor. At the same time, complete analgesia is achieved and labor weakens or stops. Therefore, it is acceptable for a woman to maintain moderate levels of physical overstrain. Such an interpretation of the significance of labor pain is consistent with its modern understanding as a negative biological need that forms a functional system that ensures the process of childbirth.

Pain response levels:

Level 1 – fabric

Level 2 – segmental

Level 3 – NS, subbuttal area

Level 4 – CNS, cerebral cortex

A painful birth is more likely in the following cases:

Dysmenorrhea, painful menstruation before giving birth

At the birth of a large baby

First birth

Long lasting labor

Premature birth

Use of oxytocin during childbirth

After expiration of amniotic fluid

In case of insufficiency of ………………………… of a woman in labor

The main causes of pain during childbirth are:

Opening of the cervix, rich in nerve receptors of the highly sensitive peritoneum.

Uterine sprain

Excitation of vascular receptor fields

Myometrial contraction

Labor pain relief should be started under the following conditions:

Established labor activity

Development of regular contractions

Opening of the cervix by 3-4 cm

Severe pain and restless behavior of the woman in labor

No obstetric contraindications

Requirements for obstetric drugs:

Pain relief must be long-term

Should be carried out in the first and second stages of labor

It should be easily interrupted - it is impossible for light obstetric anesthesia to turn into deep anesthesia, when the muscles relax, gas exchange between the mother and the fetus worsens

During the operation, a deeper anesthesia is given, but also taking into account the interests of both the mother and the fetus, so as not to cause drug-induced depression.

Group of pain relief methods:

Agents that have an effect on the cortex, hence the subcortex: magnesium sulfate, morphine and its derivatives, scopolamine, hydrochloride, chloroform, nitrous oxide, GHB, Viadrin, hypnosis, CiPPOR, electroanalgesia.

Agents acting on the subcortex: veronal, pyramidon, medinal, periakton, amitaoiatria.

Spinal block: lumbar, sacral, invertebral, epidural, caudal - widely performed abroad, but the percentage increases surgical interventions, since it is paid.

Local anesthesia (infiltration, conduction).

When conducting analgesia during labor, it should be remembered that the placenta does not interfere with the passage of analgesics. The fetal respiratory center is sensitive to sedatives and analgesics, so the use of these drugs leads to respiratory depression in newborns.

General anesthesia:

In obstetrics they are used only in emergency cases, as anesthetics penetrate the placenta and depress the central nervous system of the fetus.

Inhalation anesthesia:

Nitrous oxide– used in the 1st and 2nd stages of labor. It does not prolong labor time or suppress contractions. A mixture of nitrous oxide and oxygen in equal proportions provides sufficient analgesia, the patient breathes this mixture between pushes during the second stage of labor.

Cyclopropane– used only shortly before resolution – depresses the fetal central nervous system.

Halothane– used to achieve maximum relaxation of the uterine muscles (internal rotation, bringing down the fetus by the leg, reversing the inversion of the uterus).

Atonic bleeding may develop, so the administration of the anesthetic should be short-term.

Analgesia and sedative therapy during childbirth:

Meneredine and Promethazine– the joint of a narcotic analgesic tranquilizer effectively relieves pain during childbirth. Menedine 50-100 mg with Promethazine 25 mg can be administered every 3-4 hours. The effect occurs after 45 minutes.

Butorphanol and Narbuphine– synthetic narcotic analgesics are used intravenously. The fetal respiratory center is less depressed.

Morphine– a strong narcotic analgesic, and is rarely used during the active phase of labor. Usually prescribed IM 10-15 mg to patients with frequent, painful, ineffective contractions during discoordinated labor.

Naloxone– an antagonist of narcotic analgesics, normalizes the breathing of a newborn.

Barbiturates (Sodium Thiopental, Hexenal, drugs for non-inhalation anesthesia) - after intravenous administration, 65-70% of the dose of barbiturates binds to plasma proteins, the remaining free faction has a narcotic effect. The narcotic effect of barbiturates is based on inhibition of the cerebral cortex and blockade, and the degree of fetal depression is directly proportional to the concentration of the mother’s blood.

Ataralgesia:

This is a combination of analgesics with diazepam, seduxen and other benzodiazepam derivatives. Benzodiazepine derivatives are among the safest tranquilizers; their combination with analgesics is especially indicated for severe fear, anxiety and mental stress. The combination of roperidol with seduxen has a beneficial effect on the course of labor, shortening the total duration of the period of cervical dilatation. However, there is an effect on the condition of the newborn, in the form of lethargy, low scores on the Aprgar scale, and low neuroreflex activity.

Conduction anesthesia:

* Nerve pathways– complete pain relief is achieved by blocking fibers of the 9th and 12th thoracic nerves, parasympathetic and sensory fibers, and sacral nerves.

* Paracervical blockade– effective for pain relief during contractions, including the second stage of labor. 5-10 ml of a 1% lidocaine solution is injected into the paracervical area at 3 and 9 o'clock or into the uterosacral area at 4 and 8 o'clock on both sides of the cervix. The effect occurs within 1-2 hours.

* Pudendal nerve block- Pudendal anesthesia.

* Spinal anesthesia– contraindications: bleeding, severe hypertension, disorders of the blood coagulation system.

* Epidural anesthesia.

Physiological methods of SIPPOR:

Systematic monitoring of a pregnant woman for timely detection of pathology and taking appropriate measures.

It is correct to formulate the dominant attitude towards the act of childbirth as a physiological process in order to relieve a woman of the feeling of fear that childbirth is painful.

Familiarization with the process of the birth act in order to eliminate surprises, alarming orientations.

Teaching a pregnant woman correct, reasonable behavior, performing pain relief techniques - which are a technique for toning the cortex.

SIPPOR has two links:

Women's consultation

Hospital (maternity hospital)

The effects of medications on the fetus:

Oxytocin overdose– increased uterine tone, persistent disruption of uteroplacental perfusion – development of hypoxia.

Beta blockers and sedatives – decreased heart rate variability.

Epidural anesthesia– decreased maternal blood pressure, decreased maternal blood flow – fetal hypoxia.

Sedatives– decreased fetal activity and CTG reactivity.

Alternative methods of labor pain relief include:

Changing body position:

Standing or walking

Squatting

Squatting with support

Hanging on your partner

The presence of a loved one can help:

Reducing the duration of labor

Reduce the need for painkillers

Reducing the number of surgical interventions

Reducing the number of newborns with low body weight on the Apgar scale

Reducing negative perceptions of the birth process

Childbirth is a complex and painful process. Many pregnant women worry about upcoming events and are afraid of pain. Pain, especially prolonged pain, negatively affects the human psyche. The development of medicine has made it possible to create different variants anesthesia. Today, a woman can receive pain relief during childbirth, but:

Is it safe?
How does anesthesia affect the health of the mother and the fetus?
Is anesthesia performed according to indications or can any patient choose it?

These questions worry pregnant women, and here we will examine in detail the topic of pain relief during the labor process.

In what cases is anesthesia indicated during childbirth?

The introduction of any chemical drugs into the body of the expectant mother is undesirable. Some types of anesthesia are considered relatively safe, while others can lead to complications.

Anesthesia during childbirth is not indicated for everyone; only the doctor decides whether it is necessary to administer a relaxing medication during such an important process.

Indications for pain relief:

There are a number of indications for which a doctor may prescribe mandatory anesthesia for a woman in labor.

Hypertension and some diseases of the heart and blood vessels in a woman in labor.
Diabetes.
Serious diseases of the respiratory system.
Some eye diseases.
Increased intracranial pressure.
Discoordination of labor (random intense contraction of the uterus).
The fruit is too large.
Narrow pelvis.
Cervical dystocia (excessive stretching of tissues leading to rupture of the cervix).
Psycho-emotional disorder (occurs in absolutely normal women from too long severe pain).
Gestosis (complicated form of toxicosis).
Breech presentation of the fetus or other abnormal position.
Prolonged labor (more than 10 hours).
Multiple pregnancy.

Depending on the condition of the pregnant woman, anesthesia can be prescribed by the attending physician as planned, even before the onset of labor, or according to circumstances, already during labor.

Many women want to give birth with anesthesia, even if there is no indication for this. Of course, you can order such a service, but you should understand that any anesthesia has negative consequences even if normal birth such interference in the body is extremely undesirable.

It is important to remember that any anesthesia can have negative consequences.

Types of pain relief

There are medicinal and non-medicinal (physiological) methods of pain relief during labor. Let's consider all types in detail.

Non-drug methods for pain relief

Such methods do not have a strong and quick effect, but are more designed for relaxation during contractions. But their main advantage is high security.

Massage

Physical pressure on certain points helps to significantly reduce pain during contractions. A woman can learn pain-relieving massage on her own through special courses.

Some women in labor hire a specialist at the clinic who massages the body throughout the entire period of labor. Massage not only reduces painful sensations, but also improves blood circulation, which is beneficial for the mother and fetus.

Massage can reduce pain during contractions.

Breathing exercises

Women are also taught special breathing techniques during labor and childbirth in courses. Alternating inhalations and exhalations according to a certain system is a useful and significant pain relief during childbirth. The downside is that as contractions intensify, many women forget about technique and simply do not find the strength to breathe properly.

Hydrotherapy

Water procedures significantly relax the muscles and reduce the pain of contractions. But hydrotherapy services are provided mainly only by high-quality clinics, and not all women can afford to give birth for free.

Water treatments will help you relax and reduce pain from contractions.

Transcutaneous electroanalgesia

Quite effective and safe way, which allows you to anesthetize the course of contractions. For this purpose, a special apparatus equipped with electrodes is used. Sensors are attached to the lower back of the woman in labor and are triggered electrical impulses, the frequency and intensity of which can be adjusted. The current blocks pain signals traveling along nerve endings spinal cord. Electroanalgesia also improves blood circulation, reducing the risk of fetal hypoxia.

Psychotherapy

A pregnant woman can resort to the services of a psychotherapist and reduce her pain through hypnotic techniques. This is a wonderful way to reduce pain and create a deep positive attunement to the birth process and subsequent events.

The list of natural physiological methods also includes pain relief during childbirth by taking special positions. This kind of “gymnastics” is taught to pregnant women at preparatory classes. A specialist in the maternity hospital can help you find relaxing positions.

On a note! Some have analgesic and relaxing effects essential oils(ylang-ylang, mint, bergamot, orange, jasmine). Inhaling the aromas of these oils goes perfectly with the ones described above. physiological methods and enhances their effect. Another addition could be pleasant, calm music..
Many aroma oils have a relaxing effect on the body.

Drug pain relief

Used for drug anesthesia chemicals, acting quickly and efficiently. They completely block pain, but each of them has its own side effects. Let's consider all types of drug anesthesia acceptable for pregnant women.

The anesthetic is delivered through an inhalation mask. The drug used is mainly Nitrogen, less often Methoxyflurane, Pentran, Ftorotan, Trilene.

The woman independently takes the mask, applies it to her face and inhales the gas. The frequency of inhalations is done according to a certain pattern, which is selected by the doctor, focusing on the condition of the woman in labor.

Typically one of three options is selected:

Inhale the drug every half hour.
Inhale as the next contraction begins and remove the mask as soon as the spasm ends.
Breathe between contractions.

Inhalation anesthesia during childbirth is used only up to a certain point, until the cervix has dilated to 5-6 cm. Such anesthesia cannot be used further. This method is losing its relevance due to the high gas consumption and leakage in the wards.

Almost instant pain relief.
Does not harm the child.
Prevents fetal hypoxia.
It is quickly eliminated from the body.

Side effects such as nausea, vomiting, headache, dizziness, confusion, failure to respiratory system, tachycardia.

Intravenous and intramuscular injections

Drugs with narcotic or non-narcotic effects are injected into a vein or muscle area of the woman in labor.

Non-narcotic medications include painkillers such as No-shpa, Analgin, Baralgin. Tranquilizers and sedatives (Relanium, Fentanyl, Nalbuphine, Elenium) can also be used, which increase the pain threshold, reduce fear, anxiety and nervous excitability.

In extremely rare cases, a woman is given anesthetic drugs Ketamine, Calypsol, Sombrevin through a vein. They quickly and completely relieve pain, but cause a lot of side effects, so their use is undesirable.

The most commonly used narcotic medications are Promedol and Fentanyl.

Medicines are quickly eliminated from the body.
Quite a strong anesthetic effect.

Anesthetic administered intravenously or intramuscularly enters the placenta through the blood and may have Negative influence for the baby.
Short action.
There are many side effects for the patient (confusion, nausea, dizziness, vomiting, changes in heart rate, headache).

Such labor anesthesia is carried out in very rare cases when the patient for some reason cannot be given another type of anesthesia.

Intravenous injections suitable in cases where other types of anesthesia are contraindicated for a woman in labor.

Today this is one of the most optimal types of anesthesia, which is used in most cases.

The anesthetic is injected into the epidural space, located in lumbar region spine. The following medications can be used: Lidocaine, Novocaine, Ropivacaine and their analogues. The essence of the technique is the penetration of the anesthetic into the epidural space and blocking the nerve roots of the spinal cord.

The effect of the drug occurs in approximately 20 minutes. The woman completely loses sensation in the area below the waist. In the upper part of the body, sensitivity remains.

Throughout the entire period of labor, the catheter remains in the spinal region, which allows additional doses of anesthesia to be administered.

Pros of epidural anesthesia:

The woman in labor remains fully conscious and can move.
Eliminates discoordinated labor.
Does not affect the strength and frequency of uterine contractions.
Does not provide negative impact for the fruit
Doesn't increase blood pressure.
The patient's heart function remains stable.
A gentle recovery from anesthesia.

The effect of anesthesia does not begin immediately; you have to wait 20-30 minutes.
If cerebrospinal fluid leaks into the epidural space during the puncture, the woman may subsequently for a long time suffer from severe headaches.
Difficulty breathing (due to blockage of the sternum muscles).
Pain at the puncture site, subsequent inflammation, difficult healing, hematomas.
Pain in the lumbar region that persists for 2-3 months.
When a needle enters a vessel, a variety of negative reactions are possible.
In extremely rare cases, if the needle is inserted incorrectly, paralysis of the lower limbs is possible.

Despite all the risks, epidural anesthesia during the birth process is one of the safest in terms of effects on the child.

Read more about epidural anesthesia in.

Spinal anesthesia

It is immediately worth noting that epidural and spinal (spinal) are different types pain relief procedures during childbirth.

The drugs used are the same, but the needle is used spinal anesthesia is introduced deeper into the subarachnoid space itself. The effect of anesthesia occurs much faster than with an epidural, within 5 minutes.

The spinal method of pain relief requires higher qualifications of the doctor performing the puncture; the slightest mistake can lead to irreversible consequences. With this technique, the side effects are more pronounced, although there are no serious negative effects on the fetus.

It is important to know! Despite the high effectiveness of spinal anesthesia, it does not work on everyone. About 5-6% of women do not respond at all to the injection of drugs into the epidural or subarachnoid area. Approximately 15% have low level pain relief.

Paracervical anesthesia

An outdated method of pain relief, which is practically no longer used, but the expectant mother should know about it.

An anesthetic drug (Novocaine, Lidocaine) is injected directly into the lateral vaults of the vagina, that is, around the uterine os. The procedure is carried out in the first stages of contractions, when the dilation has not yet reached 8 cm. Anesthesia blocks the nerve endings of the cervix, significantly reducing pain.

Paracervical anesthesia during labor leads to a slower heartbeat in the fetus (in more than 50% of cases); due to this side effect, it was no longer used.

What type of pain relief is used after childbirth?

The birth process is divided into three stages: the period of contractions, the expulsion of the fetus and the release of the placenta. In some cases, the last, third stage in women occurs with complications. The placenta does not come out naturally after the required time and the patient needs manual cleaning.

In some cases, pain relief may also be required after childbirth.

In such a situation, anesthesia is required. If the birth took place under epidural anesthesia, then an additional dose is simply administered. In other cases it is used intravenous anesthesia short-term action (for 10-15 minutes). This time is quite enough to free the uterus from the placenta by mechanical intervention.

Some women experience perineal ruptures after the birth of their baby. When suturing, the doctor injects an anesthetic directly into the vaginal area.

After completing everything, the successful mother no longer needs pain relief. Over the next few days, you will feel quite strong cramps in your abdomen, as the uterus begins to contract, but this pain is short-lived and quite tolerable.

What type of anesthesia for childbirth is best?

It is impossible to give a definite answer to this question. In every individual case One or another type of anesthesia may be more suitable. But if you look at it objectively, it is considered the best. The most important thing is that it is carried out by an experienced specialist.

It is also worth considering that each method has contraindications.

Finally

This was everyone's review possible types anesthesia during childbirth. Despite the fear of pregnant women about upcoming events and the desire to go through this process painlessly, the decision on the need and advisability of anesthesia must be made by a doctor. Now in private clinics a woman in labor can order anesthesia if she wishes, paying a certain amount for it. But even in such cases, it is necessary to consult with your supervising doctor in advance and weigh all the pros and possible negative consequences.

There is less debate today about the fact that childbirth should be anesthetized than before. The evidence “for” is obvious: from prolonged torment, a woman loses control over herself and stops following the advice of obstetricians, risking harm to herself and the child. And here method of labor pain relief– with or without medications – is still a hotly debated topic.

Supporters natural processes We are convinced that if a woman is prepared and in the right mood for childbirth, then she can handle it herself - there are plenty of techniques, you just need to remember and apply them. Long before the appearance modern medicines the woman in labor went to a quiet place and calmly did what she needed to do. Several centuries ago, midwives appeared who possessed age-old wisdom and helped in word and deed. A little more than two centuries ago, obstetrics began to develop rapidly, and previous practices were forgotten.

Non-drug pain relief for labor: breathing

This is one of the most ancient and popular techniques in our time. Correct, rational breathing gives the mother’s body the necessary amount of oxygen, which helps relieve muscle tension and allows you to control yourself. To obtain the necessary skills, it is enough to take a course in preparation for childbirth. If you were unable to do this in advance, listen to your midwife - she will tell you how to breathe at different stages.

“Respiratory” pain relief works well for women who are capable of self-control and concentration. Otherwise, if the pain intensifies, the expectant mother, unable to cope with her emotions, will “lose” all her skills.

Methods of pain relief during childbirth: massage

There are special points that, when massaged during a contraction, can reduce pain. Some of them are accessible for independent manipulation, the rest are more difficult to reach - you will need the help of a partner. Of course, pain relief with acupressure will not be absolute, but relief will be felt. The technique is also taught in childbirth preparation courses. If the expectant mother attends classes alone, then knowledge about pain points will not be useful to her - it is not enough to influence only those located in the access zone.

A "full kit" is required. to exercise! If a woman stands up and moves actively during contractions, the pain eases. This is easy to explain: when muscles work, joy hormones are released - endorphins, which are natural painkillers. Physical activity improves blood flow in uterine arteries, which has a beneficial effect on the child’s condition. Walking and other distracting activities during childbirth may not be allowed for everyone.

If pregnancy has complications, you will have to give up vigorous activity.

Methods of pain relief during childbirth: water

Water helps you relax and relieve stress in many situations, and childbirth is no exception. Even an ordinary shower gives strength, increasing the pain threshold. Some maternity And perinatal centers equipped with bathtubs with hydromassage devices. If amniotic sac burst before the cervix dilates, water procedures excluded, since the risk of infection entering the birth canal increases.

Physiotherapeutic method of pain relief during childbirth

The physiotherapeutic method of pain relief is called electroanalgesia. Weak electrical discharges transmitted through the skin block the passage of pain impulses. Four electrodes are attached to the lower back. Holding the mode switch in her hands, the woman controls the strength of the impulse. The pain goes away only temporarily, allowing the expectant mother to take a little break from contractions. It also has contraindications, for example, varicose veins or cardiovascular diseases.

Physiotherapeutic method of pain relief: nitrogen

Story drug pain relief labor began with chloroform, then it was replaced by “laughing gas” - nitric oxide. It is still relevant today because when mixed with oxygen it helps you relax a little. They also tried opiate (narcotic) analgesics, including morphine, but not for long, noticing that the baby also fell into a kind of sleep with the mother. The substances penetrated the placenta, and the baby was born lethargic and less well adapted to the surrounding changes. Modern analgesics and tranquilizers act easily, but they also “reach” the baby. No visible harm was detected, but still...

Epidural anesthesia during childbirth

Only epidural analgesia relieves painful sensations for the entire period of contractions. The method also has “side” advantages, for example, it relieves cervical spasm, a common complication in which dilatation slows down or even stops altogether. In advanced cases, the situation becomes the reason for a caesarean section. Epidural analgesia significantly reduces blood pressure. If a woman initially has an elevated level, then this disadvantage turns into an advantage. Other options require medical intervention. The second disadvantage of this technique is its ability to slow down labor to one degree or another.

If the epidural slows down the progress of events, you cannot do without stimulants (oxytocin).

There are also less significant disadvantages that overshadow the meeting with the baby - back pain at the injection site and headache, fever, chills, trembling of large muscles, allergies.

Anesthesia during childbirth

If the doctor says that medical analgesia is necessary for medical reasons, you should not refuse it despite common sense. To remove doubts, it is better to understand the essence of each method and sensibly assess your capabilities. Information should not be obtained from dubious sources, including the Internet; contact a gynecologist, or even better, a practicing obstetrician and anesthesiologist.

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Pregnancy in a woman’s life is one of the most beautiful periods that will be remembered for a lifetime. The natural end of this period is childbirth. Childbirth, in the understanding of many women, is associated with severe pain; everyone experiences it differently. Quite often, women agree to anesthesia during childbirth because huge amount negative childbirth experiences of other women. However, it is worth understanding that childbirth is individual for everyone, and often you do not need to resort to pain relief. What is anesthesia during childbirth and when is it necessary? We will learn from our article.

Is anesthesia really necessary during childbirth?

The term "anesthesia" originally came to us from Greek language, literally it has two meanings:

A person's inability to feel anything;
Anesthesia for surgical purposes.

Today, pain relief is widely used during the birth process. Doctors strongly recommend that some women in labor use this service. This is due to the fact that childbirth is a long process, and the body of the expectant mother is individual in its own way. Some women get so tired during contractions that they have no strength left to push. To avoid this, women in labor agree to undergo anesthesia in order to rest from contractions for a while and not feel pain.

Anesthesia also has some placebo effects. Women who agreed to pain relief experience less fear of childbirth, i.e. Anesthesia also has a psychological aspect.

Anesthesia during childbirth can be either medicinal or non-medicinal. We'll talk about this below. In any case, the permissible dose of the medicine must be agreed with a specialist. In some cases, there are certain contraindications to this manipulation.

Be that as it may, when agreeing to anesthesia, a woman must understand that the medicine administered to her will definitely reach the child, therefore anesthesia has both pros and cons. Besides, total loss sensitivity during childbirth is extremely undesirable. Natural childbirth is always much better for the baby, but here the issue is decided on an individual basis. It is best to resort to anesthesia if there are indications for it.

In some cases, anesthesia is necessary for medical reasons, namely:

Increased arterial pressure in a woman in labor, a tendency to hypertension;
Preeclampsia in a pregnant woman, preeclampsia;
Cardiovascular diseases;
Respiratory dysfunction;
Diabetes mellitus in a woman in labor;
Incorrect position of the cervix;
Severe pain from the birth process in a woman, the inability to bear it;
Very large fruit;
Incorrect presentation of the unborn baby;
Explicit fear of the expectant mother before childbirth.

Depending on how the birth proceeds, the doctor decides whether to use anesthesia. There are several types of anesthesia, we will talk about them now.

medications are administered strictly according to the doctor’s indications, and non-drug methods of facilitating childbirth are available to every mother

Methods of pain relief during childbirth

Anesthesia can be either natural (non-drug) or medicinal.

Non-drug methods of pain relief during childbirth

If the woman in labor feels well and tolerates contractions normally, then medical anesthesia is not used by the doctor. Would be appropriate here natural ways relieve pain and tension, namely:

Proper breathing during contractions and pushing;
Ability to relax between contractions, distraction;
Water birth;
Contractions in correct posture, convenient for carrying them;
Aromatherapy.

There are other ways to relax during the birth process, these include:

Back massage;
Hypnosis of a woman in labor;
Acupuncture;
Taking a warm bath.

Every woman knows better herself that in this moment it will be better for her. We would like to dwell in more detail on the most effective methods of pain relief during natural childbirth.

Activity of the expectant mother during childbirth

During contractions, a woman should be moderately active: sudden movements are useless, but lying down is not very useful. Doctors advise doing light exercises physical exercise to relieve pain. Bends are useful different sides, circular movements of the pelvis, rolling from toe to heel. Many experts recommend using a fitball - contractions are easiest to endure on it, and it is very useful for blood circulation.

Breathing exercises

Breathing during childbirth is the most effective method the most painless way to endure contractions. In addition, it is beneficial for the baby - during childbirth he may experience oxygen starvation. By using correct breathing you can minimize the pain and tune in to a positive experience. Breathing exercises You can learn it yourself - in special courses for expectant mothers, or at home by watching videos on the Internet.

Massage

During the course, expectant mothers will be told what points there are on the body that can be used to reduce pain. They are located in the lumbar and sacral regions spine. If the expectant mother goes to give birth with her husband or another loved one, you can ask him to give a massage.

Water birth

There is also such a way of easy childbirth - this is birth in water. Today, this method causes a lot of controversy. But if you think that it is optimal for you, then enlist the support of an experienced midwife. Warm water helps the woman in labor relax and concentrate on contractions.

The perinatal period of a baby's life is one of the most important. Childbirth and the first hours of a child’s life leave a serious imprint on its further development.

Drug pain relief during childbirth

Anesthesia during childbirth often occurs using medicines. Below we will talk about modern medicinal methods of pain relief.

Epidural anesthesia

Epidural and spinal anesthesia are used most often in cases of natural childbirth in a woman. An epidural affects the area below the back, thereby blocking pain. It begins to act 10 - 20 minutes after administration.

Epidural anesthesia is anesthesia into the spine. How epidural anesthesia is given: the doctor inserts a catheter with medicine into the back area, through which the pain medication is delivered. During the administration of the medicine, the woman must lie still, otherwise there is a risk of getting into the wrong place. All manipulations are performed by an experienced anesthesiologist, after which he monitors the woman’s condition and decides whether a new dose of anesthesia is necessary.

This method has both advantages and disadvantages. The advantages include the following:

There is virtually no risk for the baby;
The cardiovascular system is not exposed to the aggressive effects of the drug;
An anesthetic drug can be administered throughout the entire period of labor, depending on the condition of the woman in labor.

Disadvantages of epidural anesthesia:

Some women continue to feel pain;
The procedure for administering the drug through a catheter requires high professionalism, since it is quite complex to perform;
An epidural cannot be administered to a woman in labor if rapid labor, since its effect begins after 20 minutes, which is why the question of whether everyone does it disappears by itself.;
After an epidural, your back sometimes hurts.

Among the types of anesthesia, epidural is one of the safest; there are no complications after it.

Spinal anesthesia

Spinal anesthesia begins to act immediately as soon as the drug is injected into the mother's back, blocking sensations below the chest. It works for an hour or two. In addition, for spinal anesthesia, the doctor uses a very thin needle, which is inserted into the localized area. cerebrospinal fluid. This type of anesthesia can also be used for caesarean section if you use potent medications.

Additionally, during this procedure, the woman is given a catheter into a vein to avoid possible complications.

Many mothers may be concerned about how long such anesthesia lasts. The answer is: from 2 to 4 hours. The epidural effect is 2 times less, but there are practically no consequences for the back.

Pros of spinal anesthesia:

No pain when inserting a needle into the spine;
The fetus is not at risk;
The cost is lower than epidural anesthesia;
The woman sees everything, her consciousness remains clear;
Instant effect.

However, this procedure also has disadvantages:

After pain relief using this method, the woman should lie down for several hours without getting up;
After the puncture, headaches are possible for some time;
Possible pain symptoms in back;
Development of hypotension.

Pudendal anesthesia

She is also called local anesthesia, since the doctor only numbs the perineal area. A woman may not feel this, since this is done during a contraction. The need for this anesthesia is caused by an episiotomy. Pudendal anesthesia is not harmful for both the expectant mother and the baby.

General anesthesia

General anesthesia is used during childbirth only in case of urgent need, and only for caesarean section. Indications for such a procedure may be sharp deterioration condition of the child or mother, as well as uterine bleeding. The doctor injects the patient with medicine into a vein, after which the woman falls asleep.

Why is it dangerous? general anesthesia? The fact that it affects the fetus, causes drowsiness and deterioration of blood supply, a negative effect on its nervous system and further physical development. However this best method to save both the mother and her baby.

After a while, a woman may experience dizziness, nausea, vomiting, drowsiness, and body pain, but these symptoms disappear the next day.

Inhalation anesthesia

This is an anesthesia for childbirth, which is used when the cervix is not ready to fully dilate, and the woman in labor experiences severe pain from contractions. It does not suppress the birth process, the woman quickly regains consciousness. In addition, this method is the safest.

Today, epidural and spinal anesthesia, these and other methods have their pros and cons

Postpartum pain relief

Often doctors are faced with the fact that a woman who has given birth experiences severe pain. What complications can occur after childbirth?

Spasms of the uterus caused by its contractions;
Pain at the sites of ruptures;
Inability to go to the toilet;
Pain in the chest area;
Incorrect attachment to the breast, causing cracked nipples.

If you have the symptoms described above, the doctor will suggest you drink painkillers and apply medicinal ointment. In other cases, pain rarely accompanies a woman, provided she follows the rules of hygiene.

Other methods of self-administered local anesthesia:

Shower regularly;
Cooling compress on the perineal area (you can use a bottle of water and store it in the freezer);
Do not make sudden movements;
Postpartum pads can be stored in the refrigerator to minimize pain.

Medicines for pain relief

They are divided into several types:

Antispasmodics;
Non-narcotic analgesics;
Narcotic analgesics;
Analgesics;
Sedatives.

Antispasmodics

They relieve pain well in women in labor and promote rapid dilatation of the cervix, thereby shortening the stage of labor. Antispasmodics are indicated for young women in labor and older women. There is no risk to the woman's fetus. These include: no-shpa, papaverine, buscopan.

Non-narcotic analgesics

Provide pain relief and psychological impact, relieving anxiety in a woman in labor. These include analgin and tramadol.

Narcotic analgesics

They are safe for the baby, but have a number of side effects for the mother:

Nausea, vomiting, dizziness;
Difficulty breathing;
Sharply reduce blood pressure;
Constipation;
Depression.

These include Pentazocine, Pethidine, Butorphanol, Promedol. The latter is the most effective in pain relief.

Analgesics

Some pain sensations are blocked, consciousness remains clear. have a lot negative consequences for the child and for the mother. This includes opioids and other pain medications.

Sedatives

Their action is more aimed at relieving anxiety in the expectant mother; unfortunately, they do not have the greatest effect on the fetus. in the best possible way. The baby's blood pressure may drop and the heartbeat may increase, respiratory functions. These include Diazepam, Droperidol, Thiopental.

Any painkillers analgesics carry certain risks for the baby and the expectant mother. However, their use in exceptional cases may be justified.

Pros and cons of anesthesia during childbirth

Pain relief has pros and cons. Today, opinions regarding the importance of anesthesia during childbirth are radically divided. Let's consider the advantages of childbirth with anesthesia.

Anesthesia during childbirth: why for?

It’s hard not to notice the obvious benefits of painkillers:

The opening of the cervix accelerates, and, accordingly, the time of contractions decreases;
The baby walks along birth canal more successful;
Relieving stress in a woman in labor;
Psychoprophylactic effect on fetal hypoxia.
The drug does not stay in the baby’s body, the risk is minimal.

Despite the obvious advantages of anesthesia, there are still negative consequences.

Anesthesia during childbirth: why against it?

Even though the risk is minimal, it still exists:

Inaccurate administration of the drug;
Drowsiness and lethargy of the child;
The natural dilatation of the cervix becomes difficult, labor lasts longer;
Often contractions stop, which is undesirable for the birth process;
Women in labor complain of headaches after anesthesia, nausea, and body aches.

Every woman has the right to decide for herself whether to have anesthesia during childbirth or not. You can often see on forums positive reviews young mothers regarding pain relief. Many people say that anesthesia during childbirth greatly facilitated contractions and the pushing stage.

Unfortunately, currently everything more women resort to childbirth under anesthesia without visible indications, without thinking about side effects. It is very important to listen to the doctor’s opinion and understand at what stage of labor it is done. In case of rapid labor, anesthesia is contraindicated; in difficult childbirth, it is recommended.

How much does labor anesthesia cost? The price of anesthesia varies depending on the method of anesthesia and the amount of medicine.

Is it painful to have anesthesia? This question worries many expectant mothers. However, if the health of the unborn baby is in the balance, then this issue fades into the background. Childbirth is not easy not only for you, but also for the child. No matter how high-quality modern pain relief techniques are, natural childbirth always preferable.