Methods of pain relief during childbirth. Types of natural pain relief during childbirth

The wonderful nine months of waiting have passed, very soon there will be an addition to your family. But the closer the day the baby is born, the more fears the expectant mother has. Many people want to undergo labor pain relief. But this natural process, every woman can cope quite well without anesthetic drugs.

This article will focus on the issue of labor pain relief; its pros and cons will be described in detail. You will also find out what such intervention on the part of obstetricians poses to you and your unborn child. The types can be varied. Which ones exactly? Read more about this.

Pain relief for childbirth: obstetrics, new methods

During childbirth painful sensations appear due to muscle spasm, which intensifies due to the release of adrenaline. Often a woman experiences panic attack, aggravating physical suffering.

A woman who is psychologically prepared and has consciously approached planning the birth of a baby most often does not need pain relief during labor. But there are still cases when anesthesia is performed according to doctor’s indications.

Indications for pain relief

They give pain relief during childbirth if:

premature birth;
severe pain;
long contractions;
multiple births;
C-section;
slow labor;
fetal hypoxia;
the need for surgical intervention.

If none of the above is observed, then pain relief during labor is usually not required.

Types of anesthesia

Modern medicine can imagine the following types pain relief during childbirth: medicinal and non-medicinal. In this case, your doctor must prescribe a type of anesthesia that will not harm either you or your child. It should be noted that a woman in labor cannot prescribe pain relief for herself if there is no direct indication for it.

Non-drug methods of labor pain relief

This is the most safe group methods are especially popular among obstetricians. What does this include? Effective and simple exercises, which can be started at any stage labor activity: breathing exercises, birth massage, aquatherapy and reflexology.

Despite the presence of more effective medicinal methods, many consciously refuse them in favor of non-drug options. Natural pain relief during childbirth includes:

activity;
correct breathing;
massage;
water birth;
reflexology.

The arrival of a baby is the most an important event in your life. Non-drug methods of labor pain relief, which are completely harmless and useful for both you and your baby, will help you leave only positive impressions of this day.

Activity during labor

It is very important during contractions to choose active position, not passive. Help yourself and your baby to be born.

If you have an uncomplicated birth, then choose exercises for yourself, the main thing is to make it easier for you. However, sudden movements are strictly prohibited. Take note of the following:

rolling from toe to heel;
bending forward and to the side;
rocking the pelvis, circular movements;
arching and flexion of the spine;
active walking;
swinging on a fitball.

Breathing exercises

It is worth mastering breathing techniques even before childbirth, during pregnancy. The advantage of this method is the possibility of combination with other types of pain relief. You don’t need a doctor’s supervision; you can control the process yourself. You will feel relief immediately, and most importantly, you will pull yourself together. There are several techniques for breathing exercises. If someone close to you will be present with you at the birth, then he should be familiar with these exercises in order to help you during the birth process.

How it works? You need to distract yourself from the pain by concentrating on breathing. The deeper and smoother it is, the easier it is for you and your baby, because he receives more oxygen. And if this method is used together with it, the effect will be much better, your child will feel comfortable. There are several periods during which breathing should differ:

first contractions;
increased intensity of contractions;
dilatation of the cervix;
period of pushing.

During the first contractions

This type is different in that it is smooth and deep breathing, which saturates the blood of the baby and mother with oxygen. Focus on the count. Inhale through your nose for four counts and exhale through your mouth for six counts. The lips should be folded into a tube. You are distracted from pain, gymnastics gives a relaxing effect. It can be used even during panic or severe stress to calm down.

During intense contractions

During this period you need to calm down, now is the time to use the technique dog breath. These are shallow, shallow inhalations and exhalations through the mouth, the tongue needs to stick out a little from the mouth. Don't think about how this moment you look, the maternity hospital is a place where you need to think only about your well-being and about the child, especially, believe me, you are not the only one!

Moment of cervical dilatation

This is the peak, you won’t be in more pain than now! But you have to endure it, childbirth without pain relief by medication still preferable. Now it’s worth speeding up your breathing, taking shallow, quick inhalations and exhalations. Form your lips into a tube, inhale through your nose and exhale through your mouth. When the contraction releases, calm down a little, it is better to breathe deeply and evenly. This method allows you to slightly ease the acute pain.

Period of pushing

The worst is over, there are no more contractions. Your baby will be born very soon. If the birth is not complicated, then the baby will appear after 1-2 attempts. You need to push 2-3 times per push. Don't panic, because now is the final moment, almost painless. If you feel sorry for yourself and disobey the orders of the obstetrician, you will have to use tools that will be enough painful sensations. When pushing begins, you need to take a deep breath, exhale, deep breath and hold your breath for 10-15 seconds, while pushing. Don't push anus or straining your eyes, you can get hemorrhoids, stroke and other unpleasant and dangerous consequences.

Another important announcement: the period between contractions and pushing is needed in order to rest, relax and even out your breathing. You need to exercise every day during pregnancy so that you can pull yourself together during childbirth. Bring your breathing to automaticity, and you will control yourself and make labor easier.

Other options

Modern methods of labor pain relief include a large list of various procedures, but particularly effective (non-drug) are massage, water birth and reflexology.

How to massage during contractions? There are points on the body that, by acting on them, can significantly reduce and soothe pain. In our case - sacral zone. You can do this either yourself or ask the person who is nearby. This area can be stroked, pinched, massaged, or lightly tapped. To avoid redness and irritation in the massage area, periodically lubricate the area with cream or oil.

How does water help? In a warm bath, the pain of contractions is easier to bear; water also has a relaxing effect. The expectant mother can take a comfortable position and just relax, while you will avoid chills, elevated temperature and sweating, dry skin.

What is reflexology? Modern pain management childbirth also includes a method such as acupuncture. It helps improve labor and reduce the pain of contractions. As you can see, there are a lot of options, which one you choose is your personal decision.

Drug pain relief

In addition to the above natural methods, there are more effective ones, but, accordingly, more dangerous ones. Modern methods of medicinal labor pain relief include the following:

epidural block;
spinal block;
spinal-epidural combination;
drugs;
local anesthesia;
perineal blockade;
tranquilizers.

Epidural block

Everyone has heard, but not everyone knows the intricacies of this procedure. Let's start with the fact that during childbirth it can be either partial or complete. If labor takes place naturally, then the drugs are administered on the basis that they are only enough for the first contraction (that is, contractions); during pushing, the effect of the drug ends. In this case, only pain signals in the area below the navel are blocked, motor ability remains, the person is conscious and can hear the first cries of his baby. If you wish or special indications They can also relieve pain in the second stage of labor (pushing), but this is dangerous, since you do not feel the signals of your body and labor can be significantly delayed or go completely wrong. If there is no such need, then do not anesthetize the pushing; during it, the pain is more tolerable.

Second option - In this case, a larger dose is administered than in the previous option, and is also blocked physical activity. The advantage of such anesthesia is the opportunity to immediately see and hear the baby.

Spinal block

This is also an injection that is given in the lower back, into the fluid around spinal cord. This is a less expensive method compared to epidural anesthesia.

you remain conscious;
the effect lasts two hours;
relieves pain throughout the body thoracic and below.

may cause severe headaches;
lowers blood pressure;
may cause difficulty breathing.

Spinal-epidural combination

It's relative new technology when the two above methods are combined. This anesthesia lasts much longer, while the mother remains conscious. For the first two hours, the epidural is effective.

Drugs

No matter how strange and contradictory it may sound, drugs are also used during childbirth, but extremely rarely, in special cases. What drugs are used? This:

"Promedol";
"Fortal";
"Lexir";
"Pethidine";
"Nalbuphine";
"Butorphanol".

Narcotic substances can be administered either intramuscularly or intravenously (via a catheter); the second option is the most successful, since the dosage of the drug can be adjusted. This method is good because the pain is blocked for about six hours and the woman in labor can rest. The effect occurs within a couple of minutes. Of course there is also negative sides: Breathing may slow down for both you and your baby.

Local anesthesia

It is not used to relieve pain during contractions, but it is very effective when making an incision in the vagina or stitching after a tear. The injection is made directly into the vaginal area, the effect occurs almost instantly, pain in the injection area is temporarily blocked. Neither you nor your child will experience any bad side effects.

Perineal blockade

The injection is made directly into the vaginal wall, blocking pain on only one side. This injection is given immediately before the baby is born. The effect of the drug lasts no more than an hour and has no side effects. This type Anesthesia is not suitable for the period of contractions.

Tranquilizers

Tranquilizers are used for relaxation; injections are given at the first stage, when contractions are rare and not so sensitive. Similar drug pain relief childbirth dulls awareness and has hypnotic effect, reducing the child’s activity, but does not completely relieve pain. Tranquilizers can be in the form of tablets or administered intravenously or intramuscularly. When administered intravenously, the effect is immediate.

Postpartum period

Pain relief is also provided after childbirth. For what? So that a woman can relax and gain strength. What may concern:

spasms caused by contractions of the uterus;
places of ruptures and cuts;
difficulty going to the toilet;
chest pain;
cracking of the nipples (due to improper feeding).

If the pain is caused by tears and incisions, then painkillers or ointments are suggested, but if the birth was carried out correctly and you pay attention to personal hygiene, then there should be no pain, or it should be minimal. During suturing, the doctor is obliged to numb the pain, and how this will happen should be discussed with you in advance.

There are several ways to minimize pain:

frequent and short-lived water procedures;
special cooling pad (will help avoid swelling);
store the pads in the refrigerator (they will dull the pain);
get ready for a speedy recovery;
Disturb the site of cuts and tears less (avoid infection, do not make sudden movements, this will contribute to a quick recovery);
sitting on a special cushion (exerts minimal pressure on the problem area).

Pain associated with uterine contractions goes away on its own a week after the baby is born. To reduce them:

perform special exercises;
lie on your stomach;
get a massage.

The following exercise will help with back pain: lie on a hard surface, bend your right leg at the knee and hold your knee right hand. With your left hand, point your heel right leg to the groin. Stay in this position for a few seconds, rest and repeat the exercise. If your back hurts on the left side, then do the same with your left leg.

The issue of pain relief 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. It's about about the severe pain that invariably accompanies the birth process. Of course, each person is individual, and for some women, pain during birth 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 the decisive moment, may simply not be ready to give birth to a child naturally, 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 other reasons:

As we have already said, the task of pain relief is the woman’s comfort and her readiness for the birth of a child. A quarter of women in labor pain threshold so low that, experiencing pain during contractions, some simply experience a feeling of panic, may perform inappropriate actions, and do not listen to the doctor’s instructions. In this case, the painkiller used during childbirth is designed to eliminate the woman's restless behavior.
Painful sensations are also relieved if the baby is expected to be too large, or twins, and also during long, or, conversely, premature or “rapid” labor.
It happens during birth process emergency required surgical intervention, for example, applying forceps, or removing the placenta. In such cases it is also used special drugs usually intravenous.
The use of an anesthetic is considered effective if there is a risk of fetal hypoxia, or the expectant mother has weak labor. Here the effect is directed in a slightly different direction, and not towards relieving pain. In case of hypoxia, for example, the use of such drugs reduces the risk oxygen starvation at the baby's.

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

Types of pain relief during childbirth

Pain relief techniques during childbirth can be completely different, from the use of medications to techniques that explain how to relieve pain during childbirth yourself. Let's start, perhaps, with pain relief during childbirth. modern conditions, that is, those methods the main principle of which is one or another introduction of medications into the body.

Drug pain relief during childbirth

Medicines designed to reduce pain during contractions may enter the body in different ways, from inhalations and compresses, to their intramuscular and intravenous administration. Let's take a closer look at how and how labor pain is relieved.

Inhalations

For such labor pain relief, a mixture of nitrous oxide and oxygen is used. This combination is quite effective and is used during dilatation of the cervix. The description of this method, by the way, gives an answer to the question “is labor anesthetized in the first period?”, which includes the time of dilatation. 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. Similar method relief of the prenatal period is aimed at ensuring that the woman can fully rest between contractions and gain strength that will be needed during pushing.

Sometimes a doctor, when deciding what kind of pain relief to use during childbirth, chooses a drug such as promedol. Although promedol belongs to narcotic drugs, it has been proven that its one-time use will not harm either the mother or the child. This drug is not used on last stage 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 is significantly delayed. In such cases, to give to the expectant mother to rest, the doctors put her to sleep.

Epidural anesthesia

Here, labor pain medication is injected into the back (spine) using a catheter. This method provides almost complete elimination of pain symptoms, but you need to remember that along with the pain, the ability to move independently for some time may disappear. This depends on the dosage of the drug administered; sometimes a woman can fully stand on her feet. The downside is the fact that while using this method, the woman in labor loses the ability to fully push. Therefore, shortly before the start of pushing, the administration of the medicine is stopped.

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The article describes possible types pain relief for childbirth, their advantages and disadvantages, and also indicate probable complications after anesthesia in mother and child.

Pain relief during childbirth - important process. It happens that the course and even the outcome of childbirth depends on the type of anesthesia.

“Turning off” or reducing pain helps to alleviate the condition of the woman in labor during natural delivery, as well as to perform a cesarean section, both under general and under regional anesthesia. However, at the same time, the use of anesthesia can negatively affect the health of the mother and child.

For pain relief during natural childbirth, the following can be used:

narcotic analgesic– administered intravenously or intramuscularly to reduce pain sensitivity during contractions and pushing
intravenous anesthesia– an anesthetic is injected into a vein to ensure short-term sleep for the woman in labor during the most painful procedures(for example, separation of parts of the placenta)
epidural or spinal anesthesia– anesthetizes the period of contractions and dilation of the cervix, carried out by injecting an anesthetic into the epidural (spinal) area
local anesthesia– used for painless suturing of tears and incisions, injected directly into the area that needs to be numbed

During caesarean section, anesthesia may be used:

general– complete shutdown of the patient’s consciousness, which is achieved by administering anesthetics through venous catheter or breathing apparatus
spinal– short-term shutdown of pain-conducting nerves in the spine
epidural– blockade of pain transmission along the nerves in the spinal region, leading to loss of sensation in the lower part of the body, is achieved by injecting an anesthetic into a specific area using a special epidural needle

Spinal anesthesia in the spine during childbirth: what is it called?

Spinal anesthesia is often mistakenly called epidural. However, it is important to understand that, despite the similar action and the same puncture site, these are two completely different types anesthesia, which have a number of fundamental differences:

Spinal anesthesia is injected into the spinal space, epidural - into the epidural.
Spinal anesthesia blocks a section of the spinal cord, while epidural anesthesia blocks the terminal portions of the nerves.
For introduction spinal anesthesia use the thinnest needle, for the epidural - the thickest.
The puncture site for spinal anesthesia is the lower back, for epidural anesthesia - any spinal region.
Epidural anesthesia is carried out for 10–30 minutes, spinal anesthesia for 5–10 minutes.
Spinal anesthesia will take effect in 10 minutes, epidural in 25-30 minutes.
If spinal anesthesia does not work, the woman in labor is given general anesthesia; if epidural, the dose of analgesic is increased.
The severity of side effects (dizziness, nausea, pressure surges) after spinal anesthesia is more pronounced than after epidural.

Thus, each of these types of pain relief has its own advantages and disadvantages, but there is no need to say that any of them is safer. The most important thing is that anesthesia is performed by an experienced anesthesiologist who can competently prepare the patient for the upcoming birth.

Epidural anesthesia - indications: in what cases is it done?

Indications for epidural anesthesia:

surgical delivery is necessary ( multiple pregnancy, incorrect position child, large fetus, multiple umbilical cord entanglement)
premature baby (anesthesia allows the mother's pelvic muscles to relax, which reduces resistance and pressure on the baby during labor)
high blood pressure in a woman in labor
weak or abnormal labor, slow cervical dilatation
fetal hypoxia
painful, debilitating contractions

IMPORTANT: Some clinics practice the use of epidural anesthesia without indications. To make a woman feel comfortable and confident during childbirth, pain relief is given at her request.

Large fruit- indication for epidural anesthesia

Epidural anesthesia is performed as follows:

A pregnant woman sits with her back bent or lies down with her legs tucked to her chest.
The anesthesiologist determines the woman's body position and asks her to remain completely still.
A preliminary anesthetic injection is given to relieve sensitivity at the puncture site.
The anesthesiologist makes a puncture and inserts a needle.
A catheter is inserted through the needle, at which time the woman may feel a so-called “shot” in her legs and back.
The needle is removed and the catheter is secured with adhesive tape. It will remain in the back for a long time.
The test is carried out by introducing a small amount of the drug.
The main part of the anesthetic is administered either in small portions continuously, or once the entire dose is repeated no earlier than 2 hours after the first portion.
The catheter is removed after labor is completed.

IMPORTANT: During the puncture, the woman must remain motionless. Both the quality of anesthesia and the likelihood of complications after it depend on this.

The catheter tube is inserted into the narrow epidural space, which is located near spinal canal. The supply of an anesthetic solution blocks pain, since the nerves responsible for its transmission are temporarily “turned off”.

Video: How is epidural anesthesia given during childbirth?

IMPORTANT: If during the administration of the drug a woman feels any unusual changes in her condition (dry mouth, numbness, attacks of nausea, dizziness), she must immediately inform the doctor. You should also warn about a contraction if it begins during a puncture or administration of an anesthetic.

Complications after epidural anesthesia during childbirth

Like any medical intervention, epidural anesthesia can cause complications, including:

Low blood pressure, which is accompanied by nausea, vomiting and weakness.
Severe pain at the puncture site, as well as headaches, which can sometimes only be cured with medication. The reason for this phenomenon is the “leakage” of a small amount of cerebrospinal fluid into the epidural area at the time of puncture.
Difficulty breathing due to blocked nerves in the intercostal muscles.
Accidental ingestion of anesthesia into a vein. Accompanied by nausea, weakness, numbness of the tongue muscles, and the appearance of an unfamiliar taste.
Lack of pain relief effect (in every 20 cases).
Allergy to anesthetic, which can trigger anaphylactic shock.
Leg paralysis is very rare, but can still be a reason for epidural anesthesia.

Complication after epidural anesthesia during childbirth - headache

Each woman must decide for herself whether she needs pain relief during childbirth, if there are no direct indications for this. Undoubtedly "advantages" of childbirth with anesthesia it could be considered:

maximum labor pain relief
the opportunity to relax during childbirth without suffering from pain during contractions
prevention of pressure increase
“Disadvantages” of childbirth with anesthesia:
loss of psycho-emotional connection between mother and child
risk of complications
loss of strength due to a strong decrease in blood pressure

Consequences of epidural anesthesia after childbirth for mother

Probable negative consequences“Epidurals” for a woman in labor:

spinal cord injury resulting from high pressure administered analgesic
damage to the vessels of the epidural space, leading to hematomas
introduction of infection during puncture and further development bacterial complications(septic meningitis)
itching of the neck, face, chest, trembling hands
increase in body temperature after childbirth to 38 – 38.5˚С
urinary retention, difficulty urinating for some time after childbirth

An increase in temperature is one of the possible negative consequences after epidural anesthesia

Epidural anesthesia during childbirth: consequences for the child

An epidural anesthesia may also have an effect on a child. Negative influence. Infants born under anesthesia may experience:

heart rate drop
breathing problems, often requiring mechanical ventilation
difficulty sucking
motor disorder
encephalopathy (5 times more common than in children born without anesthesia)
disruption of communication with mother

There is no clear answer to the question about the need to use epidural anesthesia during childbirth. In each individual case expectant mother should discuss with your doctor possible consequences in case of refusal (or consent) from anesthesia and make a decision.

Epidural anesthesia must be done if there are direct links to this medical indications or the woman in labor cannot bear the pain.

A woman who is confident in her abilities and has no direct contraindications to natural childbirth without the use of anesthesia can manage without anesthesia.

Can headaches and back pain occur after epidural anesthesia during childbirth?

Severe headache and back pain - frequent consequences epidural anesthesia. These unpleasant sensations can occur for a long time after childbirth. They appear as a result of an accidental puncture of the meninges at the time of needle insertion.

IMPORTANT: Accidental damage to the meninges occurs in 3 cases out of 100. Subsequently, more than half of the affected women experience months of headaches and back pain.

To stop these pains, in most cases, repeated drug intervention is necessary.

Is epidural anesthesia given for free, second births, is it done for everyone?

Epidural anesthesia during free childbirth is done by agreement with the doctor. The cost of services and medications spent during the process of delivery using epidural anesthesia may depend on the specifics of the mother's health insurance.

Svetlana, 25 years old: I was going to give birth without pain relief. But something went wrong in the process. I panicked when the contractions turned into some kind of cramps. The neck opened very slowly, and the pain was unreal. The doctor, looking at my suffering, offered me an epidural. I agreed, which I have never regretted. The pain after the puncture subsided, I was able to calm down, relax and concentrate. I gave birth to my son easily, and neither I nor the child had any negative consequences.

Olga, 28 years old: She gave birth with epidural anesthesia. 3 weeks after giving birth, pain began to appear in the back. After each “shot”, movements are immediately constrained. It becomes impossible to turn or straighten up. The pain intensifies and repeats 5–10 times a day. I can’t bear it anymore, and I’m afraid to go to the doctor. It would be better if I gave birth myself, especially since I had no indication for an epidural.

Kira, 33 years old: It’s been 3.5 years since giving birth with epidural anesthesia, and my legs still hurt. Even at night I sometimes wake up from severe pain in the legs and back. I can no longer walk for a long time because of this. Life has turned into a nightmare.

Video: Epidural anesthesia

Childbirth - natural physiological process, but despite this, pain is an almost integral component of it. Only about 10% of women characterize labor pain, as unimportant, mainly, this is typical for 2 or 3 genera. At the same time, almost 25% of women in labor require medical supplies to reduce the intensity of sensations and prevent possible harm, both for mother and child.

What causes pain during childbirth?

During the first stage of labor, contractions of the uterus (contractions) and dilation of the cervix cause excessive irritation. nerve endings, which in turn send a signal interpreted by the brain as pain. In addition, the vessels and muscles are stretched, and the intensity of their blood supply decreases, which can also increase the severity of pain.

In the second period, the main factor contributing to the occurrence of pain is the pressure of the presenting part of the fetus on bottom part uterus, and its movement through the birth canal.

In response to increasing pain sensations, the brain generates a response from the body - increased heart rate and breathing, increased blood pressure, excessive emotional arousal.

It is worth noting that in many ways the intensity of pain during childbirth depends not only on the level of the woman’s pain threshold, but also on her psycho-emotional state. Stress, fear, anticipation of pain, and a negative attitude increase the amount of adrenaline produced, resulting in increased perception of pain. On the contrary, calmness and balance contribute to the production of endorphins (hormones of joy), which naturally block the perception of pain.

Is there pain relief during childbirth?

In 100% of cases, methods of non-drug (physiological) pain relief are indicated: proper breathing, various techniques relaxation, special poses, water procedures, acupuncture, massage. At correct use the combination of these methods in almost 75% of cases is enough to avoid resorting to medications.

If physiological methods do not produce results or there are objective medical indications related to the woman’s health, the obstetric situation or the course of the labor process, drug pain relief is used. This helps not only to reduce the suffering of the mother in labor, but also avoids negative reaction the body to pain, thereby normalizing heartbeat and breathing, lowering blood pressure and increasing blood circulation in the pelvic area.

In addition, pain relief during labor can reduce energy costs and avoid weakening of labor in cases where the duration of the first period exceeds 12 hours.

Types of pain relief during natural childbirth:

Many previously widely used methods of anesthesia and analgesia are now fading into the background due to the excessive number of side effects. These include inhalation anesthesia, which causes short-term clouding of consciousness and depresses the respiratory activity of the fetus, and intravenous administration of various analgesic drugs and antispasmodics that easily penetrate through the placenta into the fetal bloodstream.

The safest and most effective methods of regional anesthesia are considered to be epidural and spinal anesthesia.

- epidural anesthesia

With this method, under local anesthesia, an anesthetic drug (Lidocaine, Novocaine) is injected into the epidural space of the spine using a thick needle. As a rule, the procedure itself, including insertion of the catheter, takes no more than 10 minutes. The effect of the drug occurs within 15-20 minutes and lasts up to half an hour, after which, if necessary, a new dose can be administered.

Indications for the use of epidural anesthesia include:

high myopia;
low pain threshold and unstable psycho-emotional state female patients;
malposition;
premature onset of labor;
kidney diseases, diabetes, late-term toxicosis.

The decision on the need to use epidural anesthesia is made by the obstetrician-gynecologist together with the anesthesiologist, taking into account the patient’s medical history, the condition of the fetus and the course of labor.

The procedure for placing a catheter and inserting a needle is quite complex and requires certain skills and experience from the anesthesiologist.

- spinal anesthesia

The technology is not significantly different from epidural anesthesia; it is performed using a thinner needle and with a smaller amount of medication. In this case, the anesthetic itself is injected directly into the area where it is located. cerebrospinal fluid. The effect of such an injection occurs almost instantly and can last from 2 to 4 hours.

Spinal anesthesia completely blocks the transmission of impulses from peripheral nerves to the brain, so sensitivity below chest level is completely absent, while the woman in labor is completely conscious. This method pain relief is often used, both for planned and emergency operations caesarean section.

The use of spinal anesthesia guarantees an analgesic effect in 100% of cases (with an epidural there is approximately a 5% chance of failure), the procedure is practically painless, and the drugs used do not harm either the woman in labor or the fetus.

Side effects include possible headaches and back pain after the anesthesia wears off, as well as a significant decrease in blood pressure.

In what cases is anesthesia contraindicated?

There are a number of contraindications for which spinal or epidural anesthesia is strictly not recommended. These include:

low platelet levels in the blood and bleeding disorders (including after heparin administration);
bleeding;
inflammatory processes in the area of drug administration;
tumors, infections or injuries of the central nervous system;
hypotension (blood pressure level below 100 mmHg);
individual intolerance to administered drugs.

An obstacle to the administration of painkillers may be the categorical refusal of the woman in labor, without whose consent the procedure cannot be carried out.

Also, contraindications in some cases may include injuries and deformations of the spine, serious cardiovascular and neurological diseases, obesity.

Finally

In order to minimize possible negative feelings, it is important to try to get rid of the fear of pain during childbirth in advance. Most women in labor are able to cope with it on their own using natural non-drug methods, but if necessary, the doctor will always prescribe additional medications. With this in mind, you can stop worrying about the pain becoming unbearable and focus on positive thoughts about the birth of a baby.

Especially for- Elena Kichak

IN modern society more and more more women during childbirth they do not want to endure the severe pain that accompanies this process. In addition, there are situations when pain relief is truly a medical necessity. But whatever the reason, anesthesia during childbirth is used almost everywhere, and today we will talk about how exactly it is used, whether it is worth using it, and also pay attention to the variety of options for anesthesia during childbirth.

Types of anesthesia during childbirth

Anesthesia used for natural childbirth, can be divided into several categories:

Mask
Local
Intravenous
Regional

Let's look at each method in more detail.

Mask anesthesia

What is this method? The woman in labor is put on a special mask, through which the anesthetic enters the lungs. Nitrous oxide is usually used for this method. In most cases, mask, or inhalation anesthesia, simply perfectly relieves pain. In addition, in this case, the woman herself determines the dosage, that is, she inhales the anesthetic when it is really necessary, unlike other methods, when the medicine enters the body continuously.

Local anesthesia

This type is used, as a rule, to numb a specific area. Typically used during application postpartum sutures, or in the case when the doctor needs to perform a surgical intervention, for example, to make an incision in the perineum to ensure a more comfortable passage for the baby through the birth canal.

Intravenous anesthesia

Here, an analgesic, usually with a narcotic effect, is administered intravenously. Sometimes the injection is given intramuscularly or subcutaneously. The effect depends on the method. At intravenous administration the effect occurs faster, but the effect of the drug lasts less; with subcutaneous and intramuscular administration, on the contrary, the onset of relief must continue, but the pain will disappear for a longer period. This method of pain relief is used if the opening of the uterus occurs much more slowly than it should, and the woman in labor is already quite exhausted from contractions. This will provide her with a short rest.

Regional anesthesia

This method is perhaps the most common during childbirth at present. It is used both during natural childbirth and during caesarean section. Today we will talk about two types of regional anesthesia that are used more often than others.

Spinal anesthesia

During spinal anesthesia for childbirth, a painkiller is injected directly into the meninges. The effect comes quite quickly - after a few minutes the woman ceases to feel the lower half of her body. By and large, this method of pain relief is used during a “caesarean section,” but sometimes the doctor decides to perform it during natural course childbirth The duration of spinal anesthesia depends on the amount of anesthetic administered and lasts from one to several hours, depending on the situation.

Epidural anesthesia

Epidural anesthesia is also used for both natural childbirth and caesarean section. Differs from spinal in several ways key points. The anesthetic for epidural anesthesia is not injected into the membrane spinal cord, and into the epidural space, using a catheter, which ensures continuous access of the medicine to the mother’s body. As a rule, the supply of medication is stopped immediately before the process of expulsion of the fetus so that the woman can fully push. Another, and quite significant, difference of epidural anesthesia is that with it a woman can move independently, that is, the sensitivity of the lower part of the body is not lost. Although sometimes this can happen, like by-effect from exceeding the dose of the drug. Pain relief after insertion of the catheter occurs within ten to fifteen minutes.

General anesthesia during childbirth

Anesthesia should not be confused with local anesthesia, if you are discussing with your doctor the pain management methods that will be used during the birth of your baby. During anesthesia, the woman is completely unconscious, while the use of anesthesia will allow her to immediately see her baby. Anesthesia today is extremely rarely used during childbirth, perhaps only in cases where an emergency “caesarean section” is required and time for administration local anesthesia No. Reviews about childbirth under general anesthesia are not always positive, because every mother would like to see her baby immediately after his birth.