Should epidural anesthesia be used during labor?

In order to cope with pain during childbirth, you need to mentally and physically control it. Prepare in advance: ask someone to support you during labor, master the respiratory technique of pain control, find out everything about painkillers and anesthesia that are used during childbirth.

Pain during delivery can not be predicted: often a woman can easily cope on her own, and sometimes the pain becomes strong and unbearable. Difficultly controlled pain leads to muscle tone and prolongs labor. Although anesthesia can speed birth, still complete numbness slows down this process. It is important to find a middle so that a woman can move and change position during labor activity, as well as pushing when needed. Even if you want to give birth to a child without the use of pain medication, you still need to think about their possible application.

• Epidural anesthesia is considered the most effective and easily controlled method of anesthesia during childbirth.
• A small dose of epidural anesthesia does not lead to a complete numbness of the area below the waist and makes it possible to move and stiffen during fights.
• A small dose of epidural anesthesia lowers the risk of termination of labor when fetal extraction, forceps, vacuum extraction or caesarean section is required.
• Drugs that are injected during epidural anesthesia do not harm the baby. But in parallel with this anesthesia, the heart rhythm of the fetus is monitored to determine the condition of the child during childbirth.

[1], [2], [3]

What is epidural anesthesia?

Epidural anesthesia is the most effective and easily controlled method of anesthesia during labor.

It is used both for partial numbness of the lower part of the body, allowing the woman to feel contractions in order to push, or for the purpose of completely blocking all sensations during caesarean section. With a small dosage of the drug, a woman is able to move around, which makes her feel more comfortable. Epidural anesthesia is introduced through a special epidural catheter in the region of the spinal cord, from where the drug spreads to all the spinal nerve endings of the lower body. Nevertheless, the woman is conscious, since the drug does not affect the brain and the central nervous system.

Epidural anesthesia does not enter the bloodstream, so it does not harm the baby. For comparison, drugs that are administered intravenously or intramuscularly, are already within an hour through the placenta in the fetal blood. If the child is born before the drug ceases, side effects may occur, for example, difficulty breathing and intoxication. The combination of spinal epidural anesthesia is more suitable for delivery. In the space between the hard shell of the spinal cord and the vertebrae (epidural space), a special catheter is performed through the needle that is being punctured and a local anesthetic agent is injected through it.

Benefits of epidural analgesia

• Epidural substance can be injected quickly and constantly during labor and delivery.
• In some maternity homes, the mother can control the amount of anesthetic substance herself, simply by pressing the pump button.
• Epidural anesthesia does not affect the central nervous system, so both the woman and her child are conscious.
• If an emergency caesarean section is needed, the action of epidural anesthesia will be instantaneous, and the woman will immediately lose the sensitivity of the part of the body below the chest.

[4], [5], [6], [7], [8], [9]

Risk factors and disadvantages of epidural anesthesia

When using epidural anesthesia, a woman is not able to move and take a shower, so before using her, the following should be discussed with the doctor:

• ask to apply a small dosage of the drug to walk or at least stand, and this is important for the comfort of women.
• Ask if you can walk while monitoring the fetus.

Epidural anesthesia with a conventional anesthetic increases the risk:

• long-term delivery (usually with the application of epidural anesthesia a woman gives birth an hour longer);
• lowering blood pressure (hypotension), which can lead to a slowing of the heart rate of the fetus (which is why a woman is given intravenous fluid in advance and recommended lying on her side, which promotes blood circulation);
• loss of sensitivity of the lower part of the body and inability to press in fights (then there is a need for vacuum extraction, application of forceps for fetal extraction or caesarean section);
• moving the fetus to the wrong position (due to weakness of the uterus and abdominal muscles), this increases the risk of vacuum extraction or the application of forceps to extract the fetus; some experts believe that it is the incorrect position of the fetus that provokes pain, and the woman is forced to ask for the use of epidural anesthesia;
• seizures as a reaction to a medical product (it happens very rarely).

Consequences of epidural anesthesia

• During the rehabilitation period, the soreness of the back area where the catheter was placed may be observed, but this does not happen often. Some women fear that epidural anesthesia provokes chronic back pain, but this is not proven.
• Strong prolonged headache after childbirth, when the spinal cord is accidentally injured during the procedure (this happens in 3% of cases). 70% of women have a headache after childbirth.

Spinal-cerebral anesthesia presents the same degree of risk as epidural anesthesia.

Before giving birth, study all possible methods of pain control. Pain during labor is unpredictable, so you should have several alternative methods in stock.

• In addition to medical painkillers, you can apply special breathing exercises, change your position, do massage and be distracted by more pleasant topics.
• The usual mild epidural anesthesia can be combined with spinal anesthesia.
• Injection of the opium preparation gives short-term relief and reduces painful contractions.

Pandemic blockade for an hour or a little more relieves pain and is considered the safest anesthetic during labor.

[10], [11], [12], [13], [14], [15]