Modern methods of pain relief during childbirth: medical and natural pain relief. Epidural and spinal anesthesia for natural childbirth

Preparations for pain relief of childbirth really bring relief to the woman in labor. However, it should be remembered that they are prescribed strictly according to the indications, since they have a complex effect on the entire body, not only mothers, but also the child, they have side effects, and in some cases complications can also occur. That's why expectant mothers should not rely on a miracle shot or a magic pill. Fortunately, today there are many opportunities for obtaining information on how to make the birth of a baby as comfortable as possible for both him and his mother: training manuals and courses for pregnant women talk about effective self-help techniques in childbirth, one of the most effective methods among which is massage during childbirth. Thanks to it, pain can be significantly reduced. And all this - without the use of medicines and medical interventions!

Why is there pain during childbirth?

• pain is provoked by intense contractions of the muscles of the uterus,
• stretching of the birth canal and perineum,
• muscle spasms,
• compression of large vessels in the pelvic area,
• individual characteristics, such as the structure of the pelvic organs or the low pain threshold of a woman, when it is very painful even with a slight impact.
• psychological reasons: fear of childbirth, expectation of something unpleasant and unknown, general tension.

It is important for every woman preparing to become a mother to remember: there is no constant pain in childbirth. And in fights, and in attempts, unpleasant sensations increase gradually, and also gradually subside, giving way to periods of rest. And the right massage at the right time during childbirth will completely reduce pain to a minimum.

How does birth massage work?

Massage during childbirth has a beneficial effect on the entire nervous system, and through it - on the entire body of a woman: it allows you to relax, relieve nervous tension and fatigue in the muscles, distract yourself from painful sensations and even anesthetize contractions. The mechanism of such a beneficial effect of massage during childbirth is quite complicated.

Its first stage is the excitation of skin receptors in the massaged area. Then the impulse is transmitted throughout the central nervous system, in which a favorable response is formed. Massage during childbirth activates the production of natural stimulants - hormones and enzymes that play the role of natural adaptogens that contribute to the rapid adaptation of the body to a stressful situation.

In addition, massage helps to increase blood circulation and better oxygenation of tissues and organs of both the woman herself (which also has an analgesic effect on childbirth) and the fetus, which prevents the development of oxygen starvation.

7 types of massage during childbirth

It is possible for both the woman in labor and her assistant (husband, mother or midwife) who is present during childbirth to do analgesic massage during childbirth.

Follow simple rules:

• You can massage during childbirth with dry hands (the main thing is that they are warm, since a feeling of cold can provoke a reflex muscle spasm) or with the help of special creams and gels that improve gliding over the skin and may contain pain-relieving contractions components. Do not be discouraged if you forgot the massage cream during the preparations for the hospital. You can always ask the midwife for some Vaseline oil.
• It is possible to use aromatic essential oils - they contribute to deeper relaxation. But at the same time, you should find out in advance whether the expectant mother has allergic reactions to them and whether they cause an increase in blood pressure.

Which birth massage is right for you?

1. Acupressure during childbirth

Until the contractions are in full force, you can limit yourself to acupressure during childbirth. It is useful for the expectant mother to remember where there are two important points that will need to be influenced during childbirth. The first is located on the back of the hand in the recess between the thumb and forefinger (it is clearly visible if the fingers are spread wide apart). The second is on the inside of the lower leg four fingers above the ankle (this is the area of ​​​​the ankle, where the bones protrude from the outside and from the inside). Apply continuous pressure to these points, keeping your finger perpendicular to the surface of the body. Movements should be short, pulsating, and last no longer than a minute. Then you should take a break for a couple of minutes and continue the impact in a given rhythm. It is clear that both the woman in labor and her assistant can do such a massage during childbirth. The correct effect on the active points contributes to the intensification and pain relief of contractions, the cervix opens faster, and all this happens without increasing pain.

2. Stroking the abdomen during a contraction

At the beginning of each contraction, you can gently stroke the lower abdomen. To do this, place your palms on its lower part and with light movements massage the stomach with your fingertips in the direction from the center to the sides and back. At the moment of intensification of the contraction, the intensity of pressure can be increased, but only slightly. If an assistant does massage during childbirth, then it will be more convenient for him to sit behind her.

3. Massage of the sacrum during childbirth

Women who are familiar with menstrual pain often note that the sensations in the first stage of childbirth are similar to those that occur on “critical days”: the lower abdomen aches and the lower back hurts. In this case, massage in the sacrum (this is the area that is just below the waist) helps a lot. What is special about this area? The secret of the pain-relieving childbirth effect when exposed to it is simple. The fact is that the sacral nerve plexus is located here, which is associated with the organs of the small pelvis and is responsible for their innervation. When this zone is stimulated, the transmission of a nerve impulse to the uterus and other organs is blocked, thus, it is possible to reduce pain.

Massage of the sacral region can be done with one hand or both at once, with the pads or knuckles, the base or edge of the palm, a fist or a manual massager. The main thing is that the impact is intense enough: pressure, active rubbing, patting and tapping are acceptable. If desired, you can cover not only the sacrum, but also a wider area around it.

A powerful, pain-relieving contraction effect can be achieved by pressing on the dimples above the buttocks - the exit points of the sacral nerve - the impact on which brings noticeable relief.

4. Massaging the iliac bones during contractions

This method is based on the principle of transferring the source of pain. Just as we rub our temples to relieve a headache, during contractions you can rub and massage the iliac bones of the pelvis, which are located below the waist on both sides of the abdomen. You need to stimulate them both at the same time, using active rubbing. This type of massage during childbirth can be combined with the stroking of the lower abdomen already described above (in this case, hand movements should go from the ilium to the center and back), as well as with hand movements along the inguinal fold from the ilium to the perineum - this improves blood circulation in the uterus .

5. Massaging the buttocks during childbirth

Important reflex zones are also located in the buttocks - at the exit of the sciatic nerve. To find them, you need to mark an imaginary center on each buttock (as a rule, there is a small hole there, when pressed on which mild pain can occur). Rolling the center of the buttocks with your fists or pressing on these points with your thumbs helps to relax the muscles of the pelvic floor - this is a great way to distract a woman from labor pains.

6. Massaging the thighs during contractions

Rubbing the inner surface of the thighs with the palm of your hand is an excellent technique that relieves contractions. To do this, lie on your side and, pressing your palm tightly against the skin of the inner surface of the thigh, stroke it from the groin to the knee and back. As the intensity of the contraction increases, the pressure on the thigh should also increase.

7. Massage between contractions

In the period between contractions, it is not recommended to touch the skin of the abdomen, as this is fraught with too intense an extraordinary contraction. However, this is where massage really comes in handy! The assistant can stretch the woman's neck and collar area, upper back, give a general light relaxing massage of the whole body so that the woman in labor can calm down and restore strength before the next contraction. It is important to remember that lying on your back is undesirable, since the inferior vena cava can be clamped and blood circulation in the pelvic organs is disturbed.

Anesthetize contractions with massage: alone or with an assistant?

The choice of positions for massage during childbirth depends on the individual characteristics of each expectant mother: the body itself tells you exactly how it is more convenient for him to position himself during the massage: on his side, standing on all fours, lying or sitting on a fitball, in a knee-elbow position - it all depends on you.

If you have an assistant, then the choice of possible poses will be wider. For example, postures in which a woman in labor, kneeling or on straightened legs, seems to hang on her assistant, holding her hands on his neck - while the lower back relaxes well, and the partner can additionally massage her sacrum. The convenience of childbirth with an assistant lies in the fact that in this case it is possible to combine different types of massage during childbirth, for example, a woman strokes her stomach and rubs the iliac bones, while the partner acts on the sacrum.

However, the absence of an assistant does not at all mean that the anesthetic contraction of massage should be abandoned. After all, only the woman herself can know what kind of impact and on which zone she needs at the moment. So listen to your body and, focusing on your feelings, you will surely be able to choose the types of massage that are most effective for you, and help yourself to endure the period of contractions more easily.

When should you not massage?

Despite the fact that anesthetic massage during childbirth is indicated for almost all women, it is worth mentioning separately the possible obstacles to its implementation. Directly during childbirth, any touch can be extremely unpleasant for a woman. In this case, the massage will have to be abandoned.

Deviations from the normal course of labor become a serious contraindication (for example, weak labor activity, stopping the progress of the fetus through the birth canal, acute fetal hypoxia, bleeding, etc.). You will also have to refuse massage during childbirth during the installation of CTG sensors, as well as in the second stage of labor, when attempts begin.

The issue of anesthesia during childbirth is always relevant for expectant mothers and is decided each time on an individual basis, depending on many factors.

As the due date approaches, every expectant mother, one way or another, thinks about the upcoming difficulties that are associated with the birth of a child. We are talking about severe pains that invariably accompany the birth process. Of course, each person is individual, and for some women, pain during childbirth is a completely tolerable, albeit unpleasant sensation, while for others it is a source of incredible torment.

It has been proven that in most cases a woman experiencing severe pain for a long time, at a crucial moment, may simply not be ready to give birth to a child in a natural way, the body is exhausted, and the woman in labor simply does not have the strength to push. To prevent this from happening, painkillers are used during childbirth.

Pain relief during childbirth can be used for a number of reasons:

1. As we have already said, the task of anesthesia is the comfort of a woman and her readiness for the birth of a child. In a quarter of women in labor, the pain threshold is so low that, while experiencing pain during contractions, some simply feel a sense of panic, may perform inappropriate actions, and do not listen to the doctor's instructions. In this case, the pain reliever used during childbirth is designed to eliminate the woman's restless behavior.
2. Pain is also relieved if a too large baby, or twins, is expected, and even during prolonged, or, conversely, premature, or "rapid" births.
3. It happens that during the birth process, emergency surgical intervention is required, for example, the application of forceps, or the removal of the placenta. In such cases, special preparations are also used, as a rule, intravenous.
4. The use of an anesthetic is considered effective if there is a risk of fetal hypoxia, or the expectant mother has a weak labor activity. Here the effect is directed in a slightly different direction, and not to relieve pain. With hypoxia, for example, the use of such drugs reduces the risk of oxygen starvation in a baby.

As for the risks associated with the use of drugs that relieve discomfort, then, contrary to popular belief that this can be detrimental to the health of the child, doctors think otherwise. As we have already said, the issue is resolved individually each time, and the effect is, of course, primarily aimed at bringing benefits, not harm. Of course, each drug has its own list of contraindications, but we will talk about this a little lower when we analyze what modern methods of pain relief during childbirth are.

Types of anesthesia during childbirth

Methods of pain relief during childbirth can be completely different, from the use of drugs to methods that explain how to anesthetize contractions during childbirth on your own. Let's start, perhaps, with the anesthesia of childbirth in modern conditions, that is, those methods, the main principle of which is one or another introduction of medicines into the body.

Medical pain relief during childbirth

Drugs designed to reduce pain during contractions can enter the body in a variety of ways, from inhalations and compresses to intramuscular and intravenous injections. Let's take a look at what and how childbirth is anesthetized, in more detail.

Inhalations

For such anesthesia of childbirth, a mixture of nitrous oxide and oxygen is used. This combination gives a sufficiently high efficiency and is used during the opening of the cervix. The description of this method, by the way, gives an answer to the question “do they give labor pain relief in the first period?”, which includes the time of disclosure. The advantage of this method is that the woman herself determines the degree of pain and takes a breath as needed.

Intravenous anesthesia

What is injected into a vein during childbirth for pain relief? Most often, these drugs, designed to provide pain relief during childbirth, are various analgesics. By the way, they enter the body not only, but also intramuscularly, and with the help of special compresses. A similar method of facilitating the prenatal period is aimed at ensuring that a woman can fully relax between contractions and gain strength that will be needed during attempts.

Sometimes a doctor, when deciding which anesthesia to use during childbirth, opts for a drug such as promedol. Although promedol belongs to narcotic drugs, it has been proven that its single use will not harm either the mother or the child. This drug is not used at the last stage of labor, otherwise this method may affect the baby's respiratory activity, in other words, it will be difficult for him to take his first breath.

Often, and especially during the birth of the first baby, a situation arises that labor activity is significantly delayed. In such cases, in order to give the expectant mother a rest, doctors put her to sleep.

Epidural anesthesia

Here, pain medication during childbirth is injected into the back (spine) using a catheter. This method provides almost complete relief from pain symptoms, but you need to remember that along with pain, the ability to move independently for some time may also disappear. It depends on the dosage of the administered drug, sometimes a woman can fully stand on her feet. The downside is the fact that during the use of this method, the woman in labor loses the ability to fully push. Therefore, shortly before the onset of attempts, the administration of the drug is suspended.

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The process of childbirth is a very exciting and painful process, which is difficult to endure not only morally, but also physically. Probably, every woman who gave birth during the contractions visited the thought of pain relief. Some say that this is an excellent way to have a normal delivery, while others believe that pain relief can adversely affect the health of the baby and the process of labor.

Methods of anesthesia during childbirth

When contractions begin and later, a woman experiences severe pain, which can sometimes provoke a malfunction of the heart, breathing and pressure. For certain indications, anesthesia may be recommended to protect the life of the expectant mother and fetus.

Medical anesthesia

1. Mask anesthesia. With the help of nitrous oxide, a woman is put into a state of anesthesia and thus helps to painlessly endure the period of childbirth, when the cervix opens. The medicine is administered by inhalation by inhalation.

2. Endotracheal general anesthesia. The medicine is injected into the lungs through the trachea and provides long-term pain relief. Also, in combination with this type of anesthesia, artificial lung ventilation is used. The anesthetic consists of several drugs, its use is possible only as directed by an obstetrician and an anesthesiologist. This type of anesthesia is used during a caesarean section.

3. Intravenous anesthesia. Anesthesia is injected into a vein, due to which the woman in labor falls asleep for a short time.

4. Local anesthesia. To reduce the sensitivity of certain parts of the body during labor, a woman can be given an intramuscular injection, which will anesthetize a separate part of the body.

5. Epidural anesthesia. A new and very popular method of pain relief during childbirth. When doing anesthesia of this type, the anesthetist inserts a small thin needle between the vertebrae of the woman in labor and through it injects an anesthetic under the hard shell of the spinal cord. So you can temporarily desensitize those parts of the body that are below the injection site. The method is good because it allows a woman to be conscious and feel pretty good.

The disadvantage of this method is that without experiencing pain during contractions, it is difficult for a woman to maintain labor and contribute to the birth of a child.

6. Drug anesthesia. When choosing a method of anesthesia, you should ask what drugs are used for anesthesia. Previously, narcotic drugs were widely used, which include tincture of opium, morphine, nitrous oxide and others. It is known that they adversely affect the health of the child to one degree or another. In modern medicine, a relatively safe analogue of these drugs is used - promedol.

In addition to standard types of anesthesia, there are non-drug methods of pain relief during childbirth.

Non-drug pain relief

1. Psycho-emotional preparation. One of the most important factors in the fight against pain during childbirth. The fact is that women who know what awaits them and understand how childbirth goes, endure contractions easier and less painfully and control themselves better.

2. Massage. Stretching, for example, the muscles of the neck, collar zone, lower back and back, you can distract a woman from pain in the abdomen and pelvis, relax tense muscles.

3. Reflexology. Acupuncture is considered a fairly effective method of pain relief during childbirth.

4. Hydrotherapy. Taking a warm bath or shower at a comfortable temperature can temporarily relieve pain and ease contractions.

Only a doctor can decide on the appointment of anesthesia during childbirth. There are certain indications for this. But if the obstetrician in the process of childbirth sees that severe and prolonged pain weakens the woman in labor, threatens her health, or that she has a low pain threshold, he must administer anesthesia so that the childbirth process ends safely and the lives of the mother and fetus are safe.

Childbirth is a complex and painful process. Many pregnant women worry about upcoming events and are afraid of pain. Pain, especially prolonged, negatively affects the human psyche. The development of medicine has made it possible to create different options for anesthesia. Today, a woman can receive pain relief during childbirth, but:

• Is it safe?
• How does anesthesia affect the health of the woman in labor and the fetus?
• Is anesthesia done according to indications or can any patient choose it?

These questions are of concern to pregnant women, and here we will analyze in detail the topic of pain relief in the birth process.

When is anesthesia indicated during childbirth?

The introduction of any chemicals into the body of a future mother is undesirable. Some types of anesthesia are considered relatively safe, others can lead to complications.

Anesthesia during childbirth is far from being shown to everyone, only the doctor decides whether it is necessary to administer a relaxing medication during such an important process.

Indications for anesthesia:

• Hypertension and some diseases of the heart, blood vessels in a woman in labor.
• Diabetes.
• Serious diseases of the respiratory system.
• Some eye diseases.
• Increased intracranial pressure.
• Discoordination of labor activity (chaotic intensive contraction of the uterus).
• Too big fruit.
• Narrow pelvis.
• Dystocia of the cervix (excessive stretching of tissues leading to rupture of the cervix).
• Psycho-emotional disorder (occurs in absolutely normal women from too long severe pain).
• Gestosis (complicated form of toxicosis).
• Breech presentation of the fetus or other incorrect position.
• Prolonged labor (more than 10 hours).
• Multiple pregnancy.

Depending on the condition of the pregnant woman, anesthesia can be prescribed by the attending physician as planned, even before the onset of labor or, according to circumstances, already during labor.

Many women want to give birth with anesthesia, even if there is no indication for this. Of course, you can order such a service, but you should understand that any anesthesia has negative consequences and during normal childbirth, such intervention in the body is highly undesirable.

Types of anesthesia

There are pharmacological and non-pharmacological (physiological) methods of pain relief during labor. Let's consider in detail all types.

Non-drug treatments for pain

Such methods do not have a strong and quick effect, but are more designed for relaxation during contractions. But their main advantage is high security.

Massage

Physical impact on certain points helps to significantly reduce pain during contractions. A woman can learn pain-relieving massage on her own in special courses.

Some women in labor hire a specialist in the clinic who massages the body throughout the entire period of contractions. Massage not only reduces pain, but also improves blood circulation, which is beneficial for the woman in labor and the fetus.

Breathing exercises

Special breathing techniques during labor and childbirth are also taught to women in courses. The alternation of inhalations and exhalations according to a certain system is a useful and essential pain relief during childbirth. The downside is that with the intensification of contractions, many women forget about the technique, and simply do not find the strength in themselves to breathe properly.

Hydrotherapy

Water procedures significantly relax the muscles and reduce the pain of contractions. But hydrotherapy services are provided, basically, only by high-class clinics, and not all women can afford to give birth for a fee.

Transcutaneous electroanalgesia

A fairly effective and safe way to anesthetize the course of contractions. For this, a special apparatus equipped with electrodes is used. Sensors are attached to the lower back of the woman in labor and electrical impulses are triggered, the frequency and intensity of which can be adjusted. The current blocks the pain signals passing through the nerve endings of the spinal cord. Electroanalgesia also improves blood circulation, reducing the risk of fetal hypoxia.

Psychotherapy

A pregnant woman can resort to the services of a psychotherapist, and reduce her pain through hypnotic techniques. This is a wonderful way in which pain is reduced and there is a deep positive attunement to the birth process and subsequent events.

The list of natural physiological methods also includes pain relief during childbirth by adopting special positions. Pregnant women are taught such “gymnastics” in preparatory classes. A specialist in the maternity hospital can help you find relaxing positions.

On a note! Some essential oils (ylang-ylang, mint, bergamot, orange, jasmine) have an analgesic and relaxing effect. The inhalation of the aromas of these oils is perfectly combined with the above physiological methods and enhances their effect. Another addition can be pleasant calm music..
Many aromatic oils have a relaxing effect on the body.

Medical pain relief

With medical anesthesia, chemical preparations are used that act quickly and effectively. They completely block the pain, but each of them has its own side effects. Consider all types of medical anesthesia acceptable for pregnant women.

The anesthetic is given through an inhalation mask. As a drug, mainly Nitrogen is used, less often Methoxyflurane, Pentran, Fluorotan, Trilene.

The woman independently takes the mask, puts it on her face and inhales the gas. The frequency of breaths is done according to a certain scheme, which the doctor selects, focusing on the condition of the woman in labor.

Usually one of three options is chosen:

1. Inhale the drug every half hour.
2. Inhale with the start of the next contraction and remove the mask as soon as the spasm ends.
3. Breathe between contractions.

Inhalation anesthesia during childbirth is used only up to a certain point, until the cervix has opened up to 5-6 cm. Further, such anesthesia cannot be used. This method loses its relevance due to the high gas consumption and leakage in the wards.

• Almost instant analgesic effect.
• Does not harm the child.
• Prevents fetal hypoxia.
• It is quickly excreted from the body.

• Side effects in the form of nausea, vomiting, headache, dizziness, confusion, failure in the respiratory system, tachycardia.

Intravenous and intramuscular injections

Drugs of narcotic or non-narcotic action are injected into the vein or muscle area of ​​the woman in labor.

Non-narcotic medicines include painkillers such as No-shpa, Analgin, Baralgin. Tranquilizers and sedative drugs (Relanium, Fentanyl, Nalbuphine, Elenium) can also be used, which increase the pain threshold, reduce fear, anxiety and nervous excitability.

In extremely rare cases, anesthetic drugs Ketamine, Calypsol, Sombrevin are injected into a woman through a vein. They quickly and completely relieve pain, but cause a lot of side effects, so their use is undesirable.

Of the narcotic drugs, Promedol, Fentanyl are more often used.

• Medicines are quickly excreted from the body.
• Sufficiently strong anesthetic effect.

• Painkillers administered intravenously or intramuscularly enter the placenta through the blood and can have a negative effect on the baby.
• Short action.
• Many side effects for the patient (confusion, nausea, dizziness, vomiting, change in pulse rate, headache).

Such anesthesia of childbirth is carried out in very rare cases, when for some reason the patient cannot be given another type of anesthesia.

Today it is one of the most optimal types of anesthesia, which is used in most cases.

The anesthetic is injected into the epidural space located in the lumbar spine. As medicines can be used: Lidocaine, Novocaine, Ropivacaine and their analogues. The essence of the technique is the penetration of the anesthetic into the epidural space, and blocking the nerve roots of the spinal cord.

The effect of the drug occurs in about 20 minutes. A woman completely loses sensitivity in the area below the waist. In the upper part of the body, sensitivity is preserved.

Throughout the entire period of childbirth, the catheter remains in the spinal region, which allows you to apply additional portions of anesthesia.

Benefits of epidural anesthesia:

• The woman in labor remains fully conscious and can move.
• Eliminates discoordinated labor activity.
• Does not affect the strength and frequency of uterine contractions.
• Does not adversely affect the fetus.
• Does not increase pressure.
• The work of the patient's heart remains stable.
• Soft recovery from anesthesia.

• The effect of anesthesia does not begin immediately, you have to wait 20-30 minutes.
• If cerebrospinal fluid leaks into the epidural space during a puncture, a woman may subsequently experience severe headaches for a long time.
• Difficulty breathing (due to blockage of the muscles of the sternum).
• Soreness at the puncture site, subsequent inflammation, difficult healing, hematomas.
• Pain in the lumbar region that persists for 2-3 months.
• When a needle enters a vessel, a variety of negative reactions are possible.
• In extremely rare cases, if the needle is inserted incorrectly, paralysis of the lower extremities is possible.

Despite all the risks, epidural anesthesia during the birth process is one of the safest in terms of impact on the child.

Read more about epidural anesthesia in.

spinal anesthesia

It is immediately worth noting that epidural and spinal (spinal) are different types of pain relief procedures during childbirth.

The drugs used are the same, but the needle is inserted deeper into the subarachnoid space itself during spinal anesthesia. The effect of anesthesia occurs much faster than with the "epidural", after 5 minutes.

The spinal method of anesthesia requires a higher qualification of the doctor making the puncture, the slightest mistake can lead to irreversible consequences. With this technique, side effects are more pronounced, although there are no serious negative effects on the fetus.

It's important to know! Despite the high effectiveness of spinal anesthesia, it does not work for everyone. About 5-6% of women do not react at all to the introduction of drugs into the epidural or subarachnoid region. Approximately 15% have a low level of pain relief.

Paracervical anesthesia

An outdated method of anesthesia, which is practically not used anymore, but the expectant mother should know about it.

An anesthetic drug (Novocaine, Lidocaine) is injected directly into the lateral fornix of the vagina, that is, around the uterine os. The procedure is carried out at the first stages of contractions, when the dilatation has not yet reached 8 cm. Anesthesia blocks the nerve endings of the cervix, significantly reducing pain.

Paracervical analgesia in childbirth leads to a slowing of the heartbeat in the fetus (in more than 50% of cases), because of this side effect, it was discontinued.

What type of anesthesia is used after childbirth

The birth process is divided into three stages: the period of contractions, the expulsion of the fetus and the exit of the placenta. In some cases, the last, third stage in women passes with a complication. The placenta does not come out naturally in due time and the patient needs manual cleaning.

In such a situation, anesthesia is required. If the birth took place under epidural anesthesia, then an additional dose is simply administered. In other cases, short-term intravenous anesthesia is used (for 10-15 minutes). This time is quite enough to free the uterus from the placenta by mechanical intervention.

Some women experience perineal ruptures after having a baby. When suturing, the doctor makes an injection with an anesthetic directly into the vaginal area.

After the completion of all, the held mother no longer needs anesthesia. The following days, quite strong cramps will be felt in the abdomen, as the uterus will begin to contract, but this pain is short-term and quite tolerable.

What is the best type of anesthesia for childbirth?

A definite answer to this question cannot be given. In each individual case, one or another type of anesthesia may be more suitable. But if you look objectively, it is considered the best. The most important thing is that it is carried out by an experienced specialist.

It should also be borne in mind that each method has contraindications.

Finally

This was an overview of all possible types of anesthesia during childbirth. Despite the fear of pregnant women about upcoming events and the desire to go through this process painlessly, the decision on the need and expediency of anesthesia should be made by the doctor. Now in private clinics, a woman in labor can optionally order anesthesia, paying a certain amount for this. But even in such cases, it is necessary to consult with your observing doctor in advance and weigh all the pros and possible negative consequences.

Sometimes, passing by a ward where women in labor are waiting in the wings, I see the following picture: two women of about the same age and build, only one writhes in agony, burning her husband and swearing that he will not see any more sex, and the second lies quietly, reads a book, only occasionally being distracted by unpleasant contractions. I understand that the first lady is most likely primiparous, and for the second, everything is already familiar and the birth canal has long been ready to bring out the next person.

However, most often childbirth is a painful process that requires anesthesia. And, perhaps, I will surprise someone, but in the federal law "On the rights of patients" there is the 12th section, which says that you have the right to pain relief for any pain. Including - the pain that occurs during childbirth. Yes, yes, in a hospital room you can take a vessel and loudly beat it on the wall, shouting: “I want anesthesia with an anesthetist!!!”. And Santa Claus ... that is, the anesthesiologist must appear.

The safest anesthesia

Humanity invented the sea for pain relief drugs. But we understand that some effective methods of pain relief can be toxic to the fetus. But all the power of medicine is aimed at the birth of a healthy baby, in no case should harm be done to either the mother or the unborn child.

In this regard, the most safe method of getting rid of pain is central blockade, including its types: spinal, caudal and the most common - epidural anesthesia.

The first two anesthesias are effective, but they are administered once and are limited in duration. But epidural anesthesia is able to act for a long time, since a catheter is placed in the epidural space for a woman and painkillers can be injected through it for an arbitrarily long time (local anesthetics and narcotic drugs are often injected).

What is the difficulty of

Many people think that the installation of an epidural catheter is aerobatics, because this is picking somewhere near the spinal cord! I'll tell you a secret: in fact, placing a catheter in the lumbar spine is quite a routine procedure, even interns perform it. There are indeed difficulties: people are different, there are many variations of the anatomy of the spine, and subcutaneous fat often hides structures - but still, installing a catheter is not so difficult, honestly.

Another thing is to determine what concentration of the drug to inject, how much to inject, when to stop - the qualification of the anesthesiologist is already important here! The main postulate of medicine "Do no harm!" during childbirth is doubly important, because the doctor is responsible for two lives. It happens that an inept specialist will inject so much drug and such a concentration that a woman does not feel anything at all: no pain, no contractions - the muscles become stiff, the baby stands in the birth canal with a stake. This is really a problem, and it’s good if a cesarean saves the situation ...

"Pitfalls" and how to insure yourself

And now let's look at this procedure from the side of the anesthesiologist. Night. Maternity hospital. A woman arrives, the birth is in full swing, the woman requires anesthesia. A tired evil doctor comes. What sorts? What kind of anesthesia? He still has to defend his appendicitis, and an ambulance with a flashing light is flying along the street, they are carrying a road injury. So what - he will fully anesthetize? Yes, he doesn’t need money, he will pay himself, if only they are left behind. But you need to sit next to a woman for 8-12 hours, natural childbirth is not a caesarean section for you for half an hour of work.

And it’s good if a specialist performs caudal anesthesia (a single injection of a local anesthetic into the coccyx), but not everyone knows this method. So it is not surprising if he prescribes a banal analgin. Well, what - cheap and cheerful. Anesthesia prescribed? Appointed! Will it be effective? Of course not! But according to the law, he fulfilled his manipulation and will go, cursing, further for emergency surgical interventions.

Therefore, dear women, do not download your rights when you are already in childbirth. You can ask, but you should not demand and conflict. What if some intern comes and will learn pain relief from you? The best thing you can do is to find a good, experienced anesthesiologist beforehand, a month before the birth, and make an agreement.

Just remember that anesthesiologists do not drink, because they can go into a tailspin, do not eat sweets, because they understand that sugar is a poison, and do not smell flowers, because they have sniffed halothane to liver cirrhosis in their life. Well, that's me, by the way.

Be healthy!

Vladimir Shpinev

Photo istockphoto.com