According to statistics, only 1% of the fair sex easily tolerates generic pain. Its nature is multifaceted and has not only physiological, but also psycho-emotional background; fear increase spasms.
Many women enter the generic process with a firm decision to endure everything, but after a couple of hours, confidence melts, and they understand that anesthesia is indispensable. In modern anesthesiology, there are enough methods that help to overcome pain.
Moreover, scientists have ensured that disinfection does not harm either the mother or the baby.
One of the first painkillers was opium. In ancient Egypt, they fumigated the birth rooms of privileged persons.
Then the method of inhalation anesthesia was born – inhalation of relaxing and painkillers. Now the method has been improved: the substances permitted for anesthesia are legally regulated, the concentration and dosage are verified, special devices are created that supply gas through a breathing mask.
One of the most common inhaled anesthetics is nitrous oxide with oxygen (“laughing gas”).
How it works? The mother herself applies the mask and inhales the gas mixture, nitrous oxide quickly gets from the lungs into the blood and increases the production of “hormones of happiness”, which relax and dull the pain a little.
Overdose is excluded, because in the device supplying gas, there is a valve that restricts its flow into the lungs.
What does mom feel? “Laughing gas” has a weak and limited effect, it is rather relaxing. A woman may doze off a little, but she does not experience the promised euphoria.
The fact is that the permitted concentration of nitrous oxide, safe for mother and baby, is too low for a pronounced effect.
Contraindications and risks. The use of nitrous oxide is prohibited if the baby has intrauterine hypoxia, and the woman has respiratory system diseases.
If used correctly, the gas does not cause side effects in the mother, and in the child can cause mild oxygen deficiency.
For many years, injection analgesia with narcotic drugs has been one of the most common methods of labor pain relief in the West and in Russia. Promedol, the synthetic analogue of morphine, was the most popular among us. All narcotic analgesics are either derived from morphine or its synthetic substitutes.
These drugs are similar in action, they affect the central nervous system and increase the production of endorphins and enkephalins – “joy hormones”. Everything would be great if it were not for two serious drawbacks: in a dosage that has a long-lasting analgesic effect, narcotic injections are unsafe for the health of the mother and baby, therefore, are prohibited; in the permitted dosage, they only dull the pain for a short time.
How it works? The expectant mother is given 1 injection for the entire time of delivery (3–4 hours before giving birth, if possible, so as not to weaken labor activity), the drug enters the bloodstream and inhibits the transmission of pain impulses from receptors to the brain. Moreover, promedol, for example, changes the body’s response to pain, dulls fear and relaxes.
Soothing and analgesic effect lasts for 3-4 hours. Promedol eliminates cervical spasm, causing its relaxation and early disclosure.
What does mom feel? Tranquility and relaxation, she is conscious, but can plunge into half-sleep.
The pain dulls, but does not disappear.
Contraindications and risks. Injections are not used if the mother has an individual intolerance to narcotic drugs or she has used drugs in the past. For the baby, one-hundred percent contraindication is intrauterine hypoxia.
As a side effect may be drowsiness, respiratory depression, nausea and vomiting in mom. Narcotic analgesia can threaten depression of the child to the baby.
A newborn may need ventilation.
- a woman has painful menstruation before pregnancy;
- large child (more than 4000 g);
- first, long-lasting childbirth;
- preterm labor;
- applied stimulation of labor
“The pain must be blocked at the place of its origin!” – the scientists reasoned, and epidural anesthesia appeared. This method has indisputable advantages: effective controlled pain relief during the entire period of labor, minimal analgesic exposure to the baby’s blood, safety of use for the health of the mother and baby.
Russian and foreign anesthesiologists recognize that epidural anesthesia performed by an experienced doctor is safe in 99% of cases.
How it works? The anesthesiologist inserts a needle into the epidural space (lumbar spine, between the 2-3rd or 3-4th vertebra) and reaches the dura mater.
A catheter is guided through the needle, and an analgesic is inserted through it, which blocks the pain impulses in the nerve trunks. Anesthesia takes effect in 10−20 minutes, with a single application, the effect persists for about 2 hours.
With the constant flow of analgesic pain relief is possible throughout the delivery.
What does mom feel? After the introduction of the drug may appear weakness in the legs, pains become painless, the woman feels only a slight muscle tension.
Mom is conscious and, as a rule, in a beautiful state of mind.
Contraindications and risks. Epidural anesthesia is prohibited in the following cases:
1) unconscious state of the woman in labor;
2) lowering blood pressure to 100 mm Hg. Art. and below;
3) high intracranial pressure;
4) inflammatory processes in the area of the intended puncture;
5) sepsis (general blood infection);
6) violation of blood coagulation;
8) allergy to anesthetics used for epidural anesthesia;
9) severe mental and neurological diseases of the woman in labor;
10) patient failure.
Anesthesiologists state that side effects with epidural anesthesia occur in less than 1% of cases. As a rule, they are due to the inexperience of the doctor or the physiological characteristics of the future mother. Nevertheless it is:
- lower blood pressure;
- difficulty breathing in mom;
- mom’s headache;
- reduced bladder muscle tone;
- difficulty urinating;
- feeling of light numbness in the legs, lower torso, weakness in the legs.
For a baby, side effects are minimal, because the analgesic substance with long-term epidural anesthesia enters the mother’s body in small doses.
One of the latest discoveries is spinal anesthesia. The principle of operation and method of use are very similar to the epidural one; the same drug is used as an analgesic.
Only with spinal anesthesia, the needle is thinner, is inserted deeper and pierces the hard shell of the spinal cord. The effect is more rapid, the pain recedes in 2−3 minutes, but less long – only about 1 hour. Therefore, spinal anesthesia, as a rule, is used when attempts are close and the child is about to be born.
Leading perinatal centers actively apply the combined method of anesthesia – spinal-epidural.
How it works? Through a common catheter, an analgesic is first introduced into the spinal space, pain disappears, the uterus is preserved, and the opening is slightly enhanced. Spinal anesthesia can be done only 1 time during labor, with the combined method it is better at the beginning.
When its action passes, the analgesic is injected into the epidural space through the same catheter, but for effective pain relief a lower concentration of the drug is sufficient.
What does mom feel? There is no pain, during the spinal anesthesia (with the combined method) the woman can move and walk freely; With combined anesthesia, at the stage of epidural anesthesia, the expectant mother needs to lie down.
Since the same drugs are used in epidural and spinal anesthesia, contraindications and possible side effects are similar. And again, in the hands of a professional anesthesiologist the risks are minimal.