Public Health Daily, New Hunan Client, April 7 (correspondent Zhou Qin Shen Ziyang) The pain of childbirth is often described as the pain of "challenging human limits", and the pain of childbirth can reach 9 to 10 points if evaluated by the pain score scale, and many mothers can hardly forget the pain of tearing their hearts and lungs during childbirth, and even whenever they think of it, they will have palpitations. With the development of society and science and technology, the era of labor analgesia has arrived, and under the escort of anesthesiologists, women can give birth safely in a "painless" state.
As the first batch of national childbirth analgesia pilot units, Changsha Maternal and Child Health Hospital has carried out childbirth analgesia for nearly 20 years, with an annual delivery analgesia exceeding 5,000 cases and a delivery analgesia rate of 60%. Recently, the hospital's expert group sorted out the common problems of childbirth analgesia, taking everyone into the "past life and present life" of childbirth analgesia.
Excessive pain during childbirth can cause harm to the mother and baby
In the traditional view, the pain that women bear during childbirth is considered to be taken for granted, and in the face of the pain of childbirth, the older generation may say lightly: "It hurts a little to have a child, and it is good for the child." ”
But is this really the case? The answer is no. Severe pain not only causes psychological damage to the mother (often related to postpartum depression), but also has a greater physiological impact, including increased oxygen consumption of the mother, respiratory alkalosis, etc., which may lead to a decrease in the blood flow/oxygen content of the placenta supply, resulting in fetal acidosis, etc., which are unfavorable to the mother and child.
Over the years, doctors have explored for a long time to alleviate the pain caused by women giving birth. Starting from the use of laughing gas delivery analgesia more than 100 years ago, after continuous exploration, there are many methods used to alleviate maternal labor pain, including physical analgesia, drug analgesia, spinal anesthesia analgesia, etc. Among them, spinal canal anesthesia, especially continuous epidural anesthesia, is recognized as a safe and effective method of labor analgesia, and is known as "walkable labor analgesia". Childbirth analgesia rates in developed countries are over 85 percent, compared with just 1 percent in mainland China in 2010.
In 2019, the National Health Commission issued the Notice of the General Office of the National Health Commission on Printing and Distributing the List of the First Batch of National Birth Analgesia Pilot Hospitals, which should gradually promote labor analgesia throughout the country. Changsha Maternal and Child Health Hospital became the first batch of pilot units.
A summary of 8 common problems with labor analgesia
With years of clinical experience, Changsha Maternal and Child Health Hospital has sorted out and summarized the common childbirth analgesia questions of pregnant mothers, and solved the doubts and worries in order to choose the appropriate delivery method with a better mentality.
1. Can every woman choose to give birth to analgesia?
A: The vast majority of women who can undergo vaginal trial labour can choose to give birth analgesia, but there are also some groups that are not suitable for choice. Contraindications include: fever; history of spinal canal malformations or trauma, such as severe disc herniation, lumbar spine trauma, puncture site infection, etc.; abnormal blood tests: mainly coagulation function, platelet abnormalities and white blood cell elevation; poor cardiopulmonary, liver and kidney function; nervous system diseases. Usually, the obstetrician first evaluates whether the woman can give birth vaginally, and then the anesthesiologist evaluates whether it can be anesthetized in the spinal canal.
2. Can a woman who has previously undergone a caesarean section undergo labor analgesia?
A: Scarring the uterus is not a contraindication to labour analgesia, and if the obstetrician evaluates that it can deliver vaginally and there are no contraindications to intraspinal anesthesia, it can be closely monitored for downward delivery analgesia.
3. When is labor analgesia implemented?
A: First-time women can generally perform labor analgesia when the uterine opening is 2 to 3 cm; menstruating women can perform labor analgesia immediately after labor.
4. Is there no pain at all after labor analgesia?
A: There are individual differences in the analgesic effect of childbirth, with statistics that 85% of women are completely painless after labor analgesia, and 12% of women are relieved of pain.
5. Will labor analgesia adversely affect the fetus?
A: Postnatal health assessment of newborns found that analgesia in childbirth had no adverse effect on the health of newborns, and that newborns born to expectant mothers undergoing intraspinal anesthesia had basically no difference in scores from ordinary newborns, so overall, analgesia in childbirth was safe for the fetus.
6. Will a woman suffer from low back pain after analgesia during childbirth?
A: According to the study, the analgesia of childbirth does not increase the chance of low back and headache of postpartum mothers, and basically has no health impact on postpartum mothers. Postpartum low back pain is common, and the main cause is related to the squeezing of the lumbar spine during pregnancy and the influence of hormones in the body.
7. Does labor analgesia affect breastfeeding?
A: Studies have shown that the drug given for labor analgesia is given in a very low concentration, the dose is very small, almost impossible to monitor in breast milk, and there is no obvious effect on the newborn; and its action time is up to several hours, which can effectively cover the pain in the acute postpartum period and will help new mothers to open milk.
8. What should I do if a natural delivery does not go well and requires a transiting caesarean section?
A: After labor analgesia, expectant mothers can fully go to the ground or go to the bathroom, and more activity is also conducive to the progress of labor and smooth delivery. If the situation is urgent and requires a transitive caesarean section, the anesthesia of the caesarean section can be quickly performed directly using an indwelling epidural catheter, which can buy valuable time for the safety of the mother and baby.