Pregnancy in October is already very hard, and the pain during natural childbirth is even more worrying for many expectant mothers. The development of medicine has been able to effectively help expectant mothers reduce pain through a variety of childbirth analgesia, so that they can welcome a new life while minimizing pain.
1. What are the methods of analgesia in childbirth?
There are two major categories of labor analgesia, non-drug analgesia and drug analgesia, the former includes the use of deep breathing, meditation, massage, hot compresses, hydrotherapy, music and other methods to help expectant mothers relax, reduce anxiety, distract attention, and achieve pain relief with the assistance of professional midwives and the company of husbands or other family members.
Pharmacological analgesia is the most common form of labor analgesia, and usually we mean painless childbirth with neuraxial anesthesia, especially epidural anesthesia.
Neuraxial delivery analgesia is currently the most accurate method of analgesia at home and abroad, anesthesiologists inject analgesic drugs into the spinal canal around the spinal cord to block the transmission of pain signals, thereby effectively relieving the pain of the lower body, that is, what is often called "half anesthesia". While relieving labor pain, expectant mothers can also sleep and rest to replenish physical strength according to personal conditions, and can also walk in the delivery room to promote cervical dilation and accelerate the progress of labor.
2. Can I play painlessly?
At present, painless delivery in mainland China adopts the principle of maternal voluntariness, and when the expectant mother requests painless delivery, obstetricians and anesthesiologists jointly evaluate whether neuraxial delivery can be analgesic:
1) After evaluation, the obstetrician believes that the expectant mother has entered labor (that is, entering labor, with regular contractions and gradual strengthening, lasting 30 seconds or more), and all conditions are suitable, and she can deliver through the vagina.
2) The anesthesiologist evaluates that the expectant mother has no contraindications to neuraxial anesthesia, such as lumbar spine injury, surgery, coagulation dysfunction, low back skin infection, allergy to analgesic drugs, etc.
In general, more than 90% of expectant mothers can receive a painless birth after evaluation.
3. How to fight painless childbirth?
Generally, before the painless delivery, the midwife will give the expectant mother a drip, do fetal heart rate monitoring, and then the anesthesiologist will help the expectant mother lie on her side and bend her knees and bend the spine into a C shape as much as possible like shrimp.
After the anesthesiologist disinfects the skin of the lower back, local anesthesia is performed with a thin needle in the space between the two lumbar vertebrae to reduce the pain during puncture. After the local anesthesia takes effect, the anesthesiologist places a thin, flexible catheter into the epidural space through a needle and removes the needle. The analgesic pump is then connected through this catheter, which can be pumped continuously and in small doses, and the pain can generally be felt within a few minutes after administration, and the analgesic drug can be fully effective after 15 to 20 minutes.
During delivery, the analgesic pump will continuously pump the analgesic solution, and the expectant mother can also self-control according to the degree of pain: when the pain level increases, the expectant mother herself presses the analgesic pump's delivery device, and the analgesic pump will additionally pump the corresponding analgesic according to the set parameters. This makes it easier for expectant mothers to flexibly grasp the timing of analgesic drugs according to their own situation. Doctors and midwives can also adjust the dose of analgesic medication according to the needs of the woman and the progress of the childbirth.
4. Does painless play affect my mother?
Painless delivery can greatly reduce the pain of childbirth, help expectant mothers reduce anxiety, reduce stress, and have more physical strength, so that they can relax and actively participate in the labor process. After painless delivery, most expectant mothers can still feel contractions, that is, feel tight stomach, and can breathe more effectively and hold breath under the guidance of midwives, promote cervical dilatation and uterine contractions, and facilitate the delivery of the fetus.
Some expectant mothers will worry that painless delivery will require injections on the lower back, which will lead to postpartum low back pain. In fact, the reason for postpartum low back pain is related to the heavy burden on the waist during pregnancy, the relaxation and fatigue of the lumbar muscles affected by hormones, and the incorrect posture during postpartum breastfeeding, etc., and has nothing to do with the operation of painless delivery.
The dose of analgesic drugs used during painless delivery is very small, only 1/5-1/10 of the anesthesia dose required for cesarean section, which will not lead to serious sequelae for expectant mothers, individual expectant mothers may have mild nausea and vomiting, dizziness, numbness in the legs, etc., but these discomforts will not last too long, generally do not require special treatment, and will subside on their own after the completion of labor and painless delivery.
5. Does painless hitting affect the baby?
The analgesic drugs used in painless delivery enter the epidural space, do not directly enter the blood of the expectant mother, and a very small amount of the drug is absorbed into the blood and then enters the fetus through the placenta into the fetus very little, and will not affect the baby. Similarly, analgesic drugs that can be secreted with milk are extremely small, and breastfeeding can be carried out immediately after delivery, without waiting for the effect of painless delivery to wear.
Studies have shown that the medications used for painless deliveries do not increase fetal birth defects or cause abnormalities such as neurodevelopmental disorders in the baby.
During painless delivery, the obstetrician will closely monitor the health of the fetus through fetal heart rate monitoring, and any abnormalities can be detected and taken accordingly. Studies have shown that neuraxial delivery analgesia does not prolong labour or increase the risk of caesarean section. The World Health Organization (WHO) also points out that under the right conditions, painless delivery is safe and effective, the benefits far outweigh the potential risks, and the safety of the fetus is guaranteed when there is a qualified professional medical team to manage the care.
May every expectant mother reduce the pain of childbirth with the help of painless childbirth, cross the barrier of childbirth more comfortably, and welcome every angel baby safely.
Author: Yan Siyi, Department of Anesthesiology, Tsinghua Chang Gung Hospital, Beijing
Source: Guangming Web