Painless Delivery
Is it possible to have a painless delivery? Is there any SAFE painless method for me and my baby? It’s a very commonly asked question, you will be pleased to know the answer is a big…YES! as epidural anesthesia has made it possible, it is the most effective way of pain relief, with NO SIDE EFFECTS ON BABY, there could be few problems for mother but they are manageable.
This blog will not only give you some information about various pain relieving options during labor and will also help you to decide about the most suitable and available means of painless delivery.
Why the pain is experienced while delivery?
Pain is due to uterine contractions and stretching of pelvic tissues during delivery of baby. In the first phase of labor uterine contractions dilate the uterine opening (OS) and push the head downwards towards the birth canal, whereas in second stage baby passes through the birth canal and is delivered. All these changes are transmitted to brain through nerves and pain is felt.
How effective is deep breathing and relaxation during labor?Relaxation and deep breathing exercises are really helpful during labor. They actually reduce stimulation of nerves carrying pain sensation to brain.
What are various options for relieving labor pains?
Nowadays strong painkillers are available in form of injections and mixture of gases (Entonox), they are effective but the problem is that they make mother and baby drowsy, sometimes the breathing of newborn becomes slow which can create problems. There are also local anesthetics given at various sites like para-cervical or caudal blocks.
What is epidural anesthesia?
This anesthesia is given in epidural space, around the spinal cord, in back bone, it blocks the transmission of pain from spine to the brain. Since it acts locally and has no effect on brain, both mother and baby remain active.
How epidural anesthesia is given?
It is a two-step process:
- Back is exposed and cleaned, at first a local anesthetic injection is given to numb the skin, all you feel is a needle prick.
- A fine tube (catheter) is passed, in the space around the spinal cord, through which the local anesthetic drugs are injected. There could be a feeling of heaviness, tingling and/or numbness in legs.
What caution to take during the procedure?
It is very important to remain STILL during catheter insertion, after the procedure you are free to move. The catheter is removed after the delivery.
What is done after placing catheter?
Your blood pressure and effectiveness of epidural anesthesia will be checked regularly, further doses are given at regular intervals .
How quickly it is effective? For how long will it work?
Within 20 minutes you can feel the effectiveness of local aesthetics. It’s effect wears off after few hours. Further doses of local anesthetic can be given through catheter either by injections or infusion pumps.
What are the special instructions after catheter insertion?
Here are some of the important things to consider:
- Please lie on your side.
- Avoid abrupt movements to evade catheter displacement.
- Take plenty of clear fluids to maintain hydration and blood pressure.
Is it effective for Cesarean or assisted delivery?
Yes, it is effective for any assisted delivery (vacuum or forceps) as well as Cesarean section.
What are contraindications of epidural anesthesia?
Some of the commonly known factors are:
- Allergy to local anesthetics
- Disorders of nerves or muscles
- Serious back issues
- Surgery of back
- Bleeding disorders
- Low platelet count
- Blood thinners
- Infection at site of injection or systemic infections
- Marked obesity
What are benefits of epidural anesthesia?
The benefits are:
- It relieves pain
- Helpful in long or complicated delivery
- Beneficial for high blood pressure cases ,as it lowers blood pressure
- Mother is fully awake
- No effects on baby
What are the associated problems of catheter insertion?
There could be multiple attempts of catheter insertion or failure of insertion due to some structural problem or human error. Sometimes it does not work fully and patients feels some pain and pressure. Catheter may also can get displaced.
What are the associated risks of epidural anesthesia?
There are some known, preventable and treatable risks with epidural anesthesia such as:
- Headache
- Shivering
- Nausea
- Vomiting
- Lowering of blood pressure
- Weakness in legs
- Difficulty in passing urine
- Allergic reaction
- Local tenderness at sight of injection
- Backache
- Nerve damage in rare cases
Remember many options are available for pain relief during labor, you can choose any one of them and can switch to another, at any time during labor. Epidural anesthesia has been proved globally a safe and effective way of painless delivery.
Dr. Ayesha Azam Khan