Methods of anesthesia during childbirth. Anesthesia during childbirth - all types of anesthesia for expectant mothers

There are currently many different types and pain relief methods. The doctor chooses one or several options at once, depending on the desire of the woman (if they have discussed this in advance), depending on the condition of the woman in labor and on the condition of the child at the time of birth.

Means for anesthesia

For anesthesia of childbirth in modern anesthesiology, various methods are used. medicinal substances. In the process of preparation, premedication is carried out. Premedication includes the appointment of sedative, analgesic, anticholinergic and other drugs. The use of these funds is intended to reduce the negative impact on the body. emotional stress, prevent possible side effects associated with anesthesia, facilitates anesthesia (it is possible to reduce the concentration or dose of the drug used, the excitation phase is less pronounced, etc.) Narcosis is carried out using various medicines. Medicines can be administered intramuscularly, intravenously or by inhalation. All anesthetics act primarily on the central nervous system. The drugs acting on the central nervous system include: analgesics, tranquilizers, narcotic analgesics and others. The proposed list of drugs is far from complete, but in my opinion gives an idea of the drugs and their effects.

propanidide(sombrevin, epantol; agent for intravenous anesthesia) - when administered intravenously, it quickly binds to plasma proteins, quickly decomposes into inactive metabolites, and is not detected in the blood 25 minutes after administration. The narcotic effect occurs immediately after the introduction of sombrevin, after 20-40 seconds. The surgical stage of anesthesia lasts 3-5 minutes. Propanidide causes a more pronounced hypnotic effect than analgesic. Sombrevin crosses the placental barrier, but decomposes into inactive components after 15 minutes. There is evidence that sombrevin can lead to respiratory depression, fetal acidosis, cause allergic reactions at mother.

Ketamine hydrochloride(calypsol, ketalar; analgesic) - a half-life of about 2 hours. After intravenous administration narcotic effect occurs after 30 seconds and lasts 10 minutes; after intramuscular injection - after 5 minutes and lasts 15 minutes. Has a strong analgesic effect, does not relax skeletal muscle and does not inhibit reflexes from the respiratory tract. In pregnant women, it increases the tone of the uterus. Ketamine crosses the placental barrier and in doses of more than 1.2 mg/kg of the mother's weight causes depression of the vital important functions fetal body. There is evidence that sombrevin and ketalar also affect the body's immunological system. So, with the introduction of sombrevin, the number of T- and B-lymphocytes decreases by 15 and 4%, while with the introduction of ketalar, they increase by 10 and 6%, respectively, which indicates that ketalar is less dangerous in pregnant women with allergic diseases, with blood loss and insufficiency of the immune system. This is important, since during pregnancy there is a shift in immune system the mother's body, which consists in reducing the cellular and humoral immunity in addition, a number of immunological systems are directly related to perinatal damage to the central nervous system of the fetus.

Barbiturates(sodium thiopental, hexenal; means for not inhalation anesthesia) - after intravenous administration, 65-70% of the dose of barbiturates bind to plasma proteins, and the remaining free fraction acts as a narcotic. The basis of the narcotic action of barbiturates is the inhibition of the cerebral cortex and the blockade of synapses. Barbiturates - weak acids, having a low molecular weight, penetrate the placental barrier, and the degree of depression in the fetus is directly proportional to the concentration of anesthetic in the mother's blood.

diazepam(Relanium, Seduxen; tranquilizers) - sedatives that relieve irritability, nervousness, stressful condition. At oral administration absorbed in an amount of about 75%, the maximum plasma level occurs after 1-1.5 hours. In the liver, 98-99% of diazepam is metabolized into the enterohepatic circulation. The half-life in the blood plasma of a woman is 1-3 days, in newborns - 30 hours. In the blood of the fetus highest concentration created 5 minutes after intravenous administration. In the blood of the umbilical cord of a newborn, the concentration of diazepam is equal to its concentration in venous blood mothers when administered at a dose exceeding 10 mg or more. At the same time, the concentration of diazepam in the brain is low. In this case, the occurrence of apnea in newborns, hypotension, hypothermia, and sometimes signs of neurological depression are not uncommon. Diazepam is able to accelerate the opening of the cervix, helps to remove anxiety state in a number of women in childbirth.

Promedol(narcotic analgesic) is easily absorbed by any route of administration. The maximum plasma concentration is determined after 1-2 hours. The mechanism of action of promedol is based on interaction with opiate receptors. It has an analgesic, sedative effect, depresses the respiratory center. After parenteral administration, the analgesic effect occurs within 10 minutes and lasts 2-4 hours. Promedol has an antispasmodic effect, promotes the opening of the cervix. Easily crosses the placenta. 2 minutes after intravenous and somewhat later after intramuscular administration, a concentration occurs in the blood of the umbilical cord, approximately equal to that in the mother's blood plasma, but there may be significant fluctuations in individual fetuses depending on their intrauterine state. The more time passes from the moment of administration of the drug, the higher its concentration in the blood of the newborn. The maximum concentration of promedol and its toxic metabolite in the blood plasma of a newborn was noted 2-3 hours after its administration to the mother. The half-life of excretion of promedol from the body of a newborn is approximately 23 hours, and for the mother - 3 hours. Promedol is generally considered safe for both mother and child. However, in some cases, the drug can cause depression in the newborn due to the fact that it has a depressing effect on the processes of glycolysis and the respiratory center. Promedol, like all morphine-like drugs, has a number of disadvantages, the main of which is that in effective doses (more than 40 mg) it depresses breathing and causes severe drug addiction, can cause a state of stupor, nausea, vomiting, atony smooth muscle, constipation, depression, lowering blood pressure. Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing is restored, but the children do not immediately take the breast.

The described side effects are inherent in almost all potent analgesics, with the exception of pentazocine (Lexir, Fortral). For pain relief, non-narcotic analgesics (baralgin, analgin ...) are usually not used, since they inhibit labor.

Promedol(narcotic analgesic) is used in most Moscow clinics as an anesthetic. Promedol has an analgesic and antispasmodic effect (helps to accelerate the opening of the pharynx). Promedol is injected into the buttock or thigh. Promedol manifests itself in different ways. It has a calming effect on someone, relaxes, causes drowsiness, although consciousness is completely preserved. For someone else, some women lose control of themselves, feel intoxicated, can feel sick and stagger.

Pentazocine(lexir, fortral; narcotic analgesic) - is indicated for pain relief in childbirth. It has a stimulating effect on hemodynamics and respiration, and also has a labor-stimulating effect. Does not have a pronounced sedative effect. This drug is considered to be non-narcotic, incapable of causing addiction, that is, an analgesic without a psychometic effect.

Diprivan(propofol) is a new intravenous anesthetic of ultrashort action. Diprivan quickly induces sleep, supports the inclusion of consciousness throughout the infusion (infusion) of the drug with fast recovery consciousness after stopping the infusion, has less than other intravenous anesthetics side effect. However, a number of publications point to possible unwanted manifestations diprivan during anesthesia, including the deterioration of some parameters of central hemodynamics, although data on this issue are extremely contradictory. From the point of view of pharmacology, Diprivan is not an anesthetic, but a hypnotic.

Nitrous oxide(means for inhalation anesthesia) - is one of the components of general anesthesia for caesarean section. The drug is insoluble in lipids. Very quickly (2-3 minutes) is absorbed and excreted by the lungs unchanged. 5-10 minutes after the start of inhalation, tissue saturation with anesthetic reaches a maximum. In 5-6 minutes, it is completely removed from the blood. Relatively weak anesthetic with a high degree of safety when mixed with oxygen. It affects only the central nervous system, does not depress respiration, the cardiovascular system, does not negative influence on the liver, kidneys, metabolism, contractile activity uterus. It quickly crosses the placenta, after 2-19 minutes the concentration of nitrous oxide in the blood of the umbilical vein is 80% of the level in the mother's blood. Prolonged inhalation of nitrous oxide is sometimes accompanied by the birth of a child with low Apgar scores.

They give nitrous oxide through a special apparatus using a mask. The woman in labor is introduced to the technique of using nitrous oxide; in the future, she herself puts on a mask and inhales nitrous oxide with oxygen during contractions. In the pauses between contractions, the mask is removed. Nitrous oxide in a mixture with oxygen significantly reduces pain, without removing it completely, and causes euphoria. Apply it at the end of the first stage of childbirth. The action of the gas manifests itself in half a minute, so at the beginning of the fight, you need to take a few deep breaths. The gas dulls the pain, inhaling it makes a woman feel dizzy or nauseous. Nitrous oxide is usually given in combination with narcotic analgesics.

Relaxants(dithylin, listenol, myorelaxin; muscle relaxants) - slowly and incompletely absorbed into digestive tract. Do not cross the placenta. Cause permanent muscle relaxation. These relaxants do not affect the condition of the newborn, but in some newborns with impaired feto-placental permeability, some authors note low score on the Apgar scale.

The use of drugs for the treatment of pain and anxiety in parturient women involves the use of anesthetics and analgesics, both narcotic and non-narcotic, and their combination with sedatives and neuroleptics.

General anesthesia

More often general anesthesia used for delivery by caesarean section. General anesthesia affects not only the woman in labor, but also the child.

Method of neuroleptanalgesia

Enough wide use for pain relief received the method of neuroleptanalgesia, which provides a kind of mental peace, satisfactory analgesia, accompanied by stabilization of hemodynamic parameters and the absence of a significant effect on the nature of labor activity.

Fentanyl is administered intramuscularly. Greatest effect achieved when combined with droperidol. If necessary, a second dose is administered after 3 to 4 hours.

Neuroleptanalgesia is not recommended if the patient has severe hypertension (high blood pressure), increased tone bronchioles. You need to be prepared for development opportunities drug depression newborn. Narcotic analgesics have a depressive effect on the respiratory function of the newborn.

Ataralgesia method

Another common method of labor pain relief. The method of ataralgesia is a combination of analgesics with diazepam, seduxen and other benzodiazepam derivatives. Benzodiazepan derivatives are among the safest tranquilizers, their combination with analgesics is especially indicated for severe fear, anxiety and mental stress. The combination of dipyridol with seduxen favorably affects the course of labor, shortening the total duration and period of cervical dilatation.

However, there is an effect on the condition of the newborn, in the form of lethargy, low scores Apgar score, low neuroreflex activity.

Epidural analgesia method

This method has been well studied. The beneficial effect of epidural analgesia during pregnancy and childbirth complicated by preeclampsia, nephropathy, late toxicosis is important, during labor pain relief in the breech presentation of the fetus, it favorably affects the course premature birth, reducing the period of opening of the cervix and lengthening the period of exile, which contributes to a smoother advancement of the head. At the same time, under the action of epidural analgesia, the muscles of the perineum relax and the pressure on the fetal head decreases. It is indicated for congenital and acquired heart defects, with chronic diseases lungs and kidneys, with edema, with myopia (nearsightedness) and damage to the retina.

At the same time, epidural analgesia may cause a decrease in uterine activity. There was also an increase in the duration of labor and a decrease in uterine activity in the second stage of labor during epidural analgesia, which contributed to an increase in the number of operative deliveries (forceps, Caesarean section). It is also known about the negative hemodynamic effect. In addition, there is hypotension of the bladder, fever (hyperthermia).

Currently used for epidural analgesia various drugs(local anesthetics, narcotic and non-narcotic analgesics, diazepam, ketamine). In pregnant women, lidocaine is most commonly used. Lidocaine is metabolized in the liver. Often there is cumulation (accumulation) of the drug, which subsequently manifests itself as neuro- and cardiotoxicity in relation to the mother and fetus.

Epidural analgesia provides long-term and highly effective pain relief from the onset of labor until the birth of the child, but can lead to serious complications.

The principle of operation of epidural analgesia in childbirth is that the anesthetic is injected into the epidural space and blocks the subdural nerves in the segments from T10 to L1. It is effective when contractions cause severe back pain and changes in position do not help or are difficult. Its time should be calculated so that the effect of the anesthetic ceases by the second stage of labor, otherwise it is possible to slow down labor and increase the risk of episiotomy and forceps. Anesthesia should be terminated by the onset of attempts. This period requires a woman's "personal" participation. Anesthesia is not stopped in the second stage of labor (the period of attempts), if there is special indications such as myopia.

Standard technique for epidural analgesia in labor

IN obstetric practice Combined subdural-epidural anesthesia and analgesia are used. The epidural space is punctured with an epidural needle, through which a needle is then inserted to puncture the subdural space. After removal of the subdural needle, the epidural space is catheterized. The main application of the method is the administration of narcotic analgesics for effective pain relief contractions followed by the use of continuous infusion epidural analgesia from the end of the first stage of labor.

An epidural anesthesia takes about 20 minutes to complete. The woman is asked to curl up with her knees resting on her chin. The puncture is performed in a position on the side or sitting. Many anesthesiologists use the sitting position for puncture, since in this position the midline of the back is more easily identified, which is often difficult due to swelling of the subcutaneous tissue of the lumbar region and sacrum. The back is treated with an anesthetic solution. After local anesthesia, the skin is punctured with a thick needle to facilitate subsequent insertion of the epidural needle. The epidural needle is slowly advanced into the interspinous connection (the doctor inserts a hollow needle into intervertebral disc). A syringe is attached to it. Anesthesiologist introduces anesthetic syringe in the lower back. The medicine is delivered through a tube inside the needle as needed. The needle is not removed, which allows you to enter an additional dose if necessary. The anesthetic wears off after 2 hours. It may be accompanied by some difficulty in movement and trembling in the hands. Some women experience weakness and headache, as well as heaviness in the legs, which sometimes lasts for several hours, pruritus, urinary retention.

Like all methods of anesthesia, this anesthesia has a number of side effects and complications. Epidural anesthesia with concentrated solutions of local anesthetics can increase the duration of the first and second stages of labor, and then there is a need for oxytocin (oxytocin increases uterine contractility) or operative delivery.

Side effects such as respiratory depression, lower back pain, temporary numbness of the limbs, headache, dizziness, nausea, vomiting, pruritus, depression. Any discomfort should be reported to the doctor immediately! The most dangerous of the complications is inflammation of the peredural space, which can appear on the 7-8th day. This happens when the rules of asepsis and antisepsis are poorly observed. Another complication is hypotension (low blood pressure). It occurs as a result of an overdose of the drug, so that this does not happen, the woman in labor is administered drugs that increase vascular tone.

A competent and highly qualified doctor, understanding the seriousness of the entire procedure, will explain to the woman all the pros and cons and, without special need, will not perform epidural anesthesia, simply because he was asked. Most anesthesiologists discuss with women the effectiveness and benefits of this method for both mother and child and the risk possible complications. After that, the woman signs papers stating that she is familiar with all the pros and cons and agrees to this procedure. ("The anesthesiologist's desire to obtain written consent is a natural self-protection; the obstetrician should record in her notes that the woman consents to epidural analgesia, and it would be wise for the anesthesiologist to simply sign this record.") Take your time with a normal pregnancy and normally developing labor activity to do an epidural.

Another conversation when the only way anesthetize childbirth and conduct them safely. Then try, after talking with the doctor, to tune in to this procedure as favorably as possible! positive attitude is 90% success! In the process of choosing, you can doubt, ponder, weigh, choose what is best for you now, BUT, when you have made a decision, follow only it! Fuss and throwing in the mind will only spoil the matter.

Women who are subsequently dissatisfied with epidural analgesia in labor usually come to the maternity hospital with a stable attitude towards this method of pain relief and agree to its implementation only when the time for detailed explanations not anymore. It is necessary to adhere to the tactics of "explain, but not persuade. This means that when explaining to a woman all the advantages of spinal methods of anesthesia, one should not insist on their choice. This is due to the fact that when analyzing complications, it often turns out in retrospect that most of the troubles occur in those women who categorically refused to undergo epidural anesthesia or analgesia, but succumbed to the persuasion of the doctor Apparently, there is something more serious than our ideas about clinical physiology spinal methods of anesthesia. Certainly, perfect time to discuss with future parents the role of spinal methods of anesthesia - before childbirth".

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 who experiences severe pain for a long time, at a 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 reasons:

As we have already said, the task of anesthesia is the comfort of a woman 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 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.
Pain is also relieved if a too large baby, or twins, is expected, and even during prolonged, or, conversely, premature, or "rapid" births.
It happens that during the birth process an emergency is required surgical intervention such as insertion of forceps, or removal of the placenta. In such cases, also apply special preparations usually intravenous.
The use of pain medication is considered effective if there is a risk of fetal hypoxia, or in future mother weak generic 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 different ways, from inhalations and compresses, to their introduction intramuscularly and intravenously. 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. Similar method 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 refers to drugs, it has been proven that its single use will not harm either the mother or the child. This drug is not used for last stage labor activity, 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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Unfortunately, none of the currently known methods medical anesthesia childbirth is not perfect. All of them, one way or another, affect the fetus and the duration of labor, and their use is not always possible. However, there are methods of pain relief that do not have any contraindications for mom and baby.

Methods of non-drug pain relief are absolutely harmless, very simple and effective, they can be used at any stage of childbirth. Self-healing methods include birth massage, special breathing techniques, relaxing postures and movement techniques, the use of a fitball (gymnastic ball) and water therapy during childbirth. In order to master these techniques, only one thing is required - desire!

active position

First and the most important factor reducing pain from contractions is active behavior in childbirth. This term refers to the free behavior of the woman in labor, the constant change of positions and movement around the ward, the search for the most comfortable body position. By themselves, movement significantly reduces the overall sensation of pain. And not only because any action is distracting.

Firstly, the level of pain sensation depends on blood circulation. During a contraction, the muscle fibers of the uterus contract, while expending energy. The main "energy fuel" for the work of all cells in our body is oxygen; myometrial cells (uterine muscles) are no exception. As you know, oxygen is arterial blood; therefore, cell respiration depends on the level and speed of arterial blood flow. When the body is stationary, the total blood flow decreases, the supply of oxygen to the uterine muscle slows down, and pain increases. If a woman in labor walks around the ward or moves in a comfortable position, as a result of the movement, the level of blood flow increases, and the cells of the uterus are better supplied with oxygen. Therefore, with active behavior in childbirth, pain from contractions is much weaker than with a stationary position. Even in the case when medical indications a woman in labor should not get up, she can actively behave during a fight - sway, spring on the bed, spread and bring her knees together. These small movements significantly reduce the pain of a contraction.

Secondly, the feeling of pain depends on the general tension. More precisely, between these concepts - pain and tension - there is a direct proportional relationship. That is, the more we strain, the more painful it is for us, and vice versa. During a contraction, when the uterus tightens and painful sensations appear, some women instinctively “freeze”, completely stopping moving. This behavior of the woman in labor is caused by fear of pain. The woman in labor, as it were, hides for the duration of the contraction from pain and from herself. In childbirth, this behavior does not bring relief: "freezing", the expectant mother unconsciously strains, which leads to a sharp increase in pain. The main assistant in the fight against excessive tension during contractions is physical activity. After all, when we are in motion, our muscles alternately tense and relax; therefore, hypertonicity (excessive muscle tension) is excluded. And if the movement helps to relax, then it reduces general level pain.

Movements during childbirth can be very diverse. If the birth proceeds without complications, the choice of the type of movements during the contraction remains with the woman in labor. In this case, there is one, but very important limitation. At any stage of childbirth, sharp, jerky movements should not be made. Here are examples of the most common active behaviors during a fight:

walking along the ward or corridor;
tilts to the sides and forward;
sipping and turning the whole body;
shaking and rotating movements of the pelvis;
shifting from foot to foot;
transfer of body weight from socks to heels and vice versa;
half squats;
bending and arching of the spine;
in the prone position: swinging the pelvis, turning from side to side, springy movements of the hips, bringing and spreading the legs.

During fights, you should behave freely, choosing the most comfortable position of the body. There are many well-known positions that reduce discomfort during contractions and help you relax. The main principle by which a woman in labor chooses a position for the duration of the contraction is the level of comfort, stability and relaxation. Most "generic" poses use four points of support and predominantly vertical position body; there are also "lying" poses. However, in order for the postures to help, you should change the position of the body as often as possible and do not forget to move a little within any posture. To reduce pain during childbirth, try the following positions during labor:

Stand by the bed (sink, window sill, bedside table) with your legs slightly apart. Lean your hands on the bed, relax your back and stomach, as if transferring the weight of your body to your arms and legs. Swing from side to side, back and forth, shift from foot to foot, shake your pelvis.
Stand in the position of a sumo wrestler: legs wide apart and half-bent at the knees, the body is slightly tilted forward, hands rest on the middle of the thighs. Shift from foot to foot or sway from side to side.
Squat down with your legs wide apart and leaning on a full foot. Behind the back there should be a fixed support (headboard, bedside table, wall). Stand with your feet shoulder-width apart, put your hands on your hips. Swing left and right, back and forth. Get on the bed on all fours with your legs slightly apart. Alternately arch and arch your back at the spine.
Stand on the bed in a knee-elbow position, legs slightly apart, and sway from side to side. You can put a pillow under your elbows. Kneel on the bed, rest your hands on the back of the bed, Shift from one knee to another. Squat down facing the bed. Hands and head can be put on the bed.
Sit on the ship, placing it on a chair or a special bench (you can’t sit on the chair itself - this creates excessive pressure on the perineum and can harm the baby). Bend your legs at the knees and spread them wide apart (both the vessel and the bench are always in the ward).
Stand at the head of the bed or bedside table. Place your arms bent at the elbows on it. Get down on your haunches, as if sagging on your hands,
If you are tired and want to lie down, lie on your side with your knees and hips bent.

There are so-called "partner positions" for which a woman in labor will need an assistant. Here are some of the simplest and most convenient positions for pain relief of contractions:

Stand facing your partner and wrap your arms around his neck, top press your body against your partner, turn your head to the side. Bend your legs at the knees, spread them as wide as possible and sway from side to side without lifting your legs from the floor.
Stand like a train in front of your partner. Ask him to put forward his arms bent at the elbows (boxer's pose). Spread your legs wide bent at the knees, lean back on your partner and hang on his arms, like on gymnastic rings, without lifting your legs from the floor and swaying (in this position, the woman in labor is fixed under the armpits on the partner’s forearms).
Ask your partner to sit on the edge of a chair or bed with your legs wide apart. Squat down with your back to your partner, legs wide apart and leaning on a full foot, Lean back on your partner and sway from side to side.
Lie on your side and ask your partner to sit next to the bed. Bend the leg located on top at the knee and rest it on the shoulder of the partner. Try to bend and unbend this leg (ask your partner to offer a little resistance to this action).

Recently, in many women in labor, they are allowed to use a fitball to anesthetize childbirth. Fitball is a rubber gymnastic ball that is commonly used for aerobics and Pilates. With the help of a fitball, you can take a wide variety of poses, easily changing one to another, guaranteed to relax and move continuously, while saving strength. For use during contractions, the fitball is not fully inflated so that it remains soft and springy. On the ball, you can take all the poses listed above; in addition, there are special poses with a fitball:

swing, rotate the pelvis, spring, roll from side to side, sitting on the ball;
get on all fours, leaning on the ball with your chest, arms and chin and swinging on it;
lie on your side, placing the ball under your side and arm and springing on it;
lean on the ball with your back in a reclining-half-sitting position with legs wide apart;
swing, pushing back from the ball; sit or kneel, leaning on the ball with outstretched arms and springing;
lie on your side, placing the ball between the calves of the legs and bouncing them.

As you can see, active behavior in childbirth does not require special physical training. In order to use the "active", you need only the knowledge and desire of the woman in labor to be a participant in childbirth, and not a passive patient.

Pain relieving breath

The most effective way to anesthetize childbirth is with special breathing techniques. The analgesic effect of breathing is based on hyperoxygenation - supersaturation of the blood with oxygen. The respiratory center of the brain, registering an excess of oxygen in the blood of a woman in labor, sends an impulse to the pituitary gland - the main hormonal gland responsible for the release of endorphins. These substances, called "pleasure hormones", regulate the threshold pain sensitivity person. The more endorphins are released, the higher the pain threshold; that is why proper breathing in contractions and attempts to anesthetize no worse than analgesics.

Breathing techniques can be used at any stage of childbirth without restrictions. They are applicable in any position of the body, they are equally effective in helping both with normal flow childbirth, and with the development of various deviations of labor activity.

At the beginning of labor, when contractions are practically painless, it is recommended to use "belly breathing". At the beginning of the contraction, the woman in labor takes a relaxed, slow breath through her nose, and then exhales air through her mouth for a long time (as if blowing on water). Such breathing helps to relax, relieves nervous excitement and provides high blood oxygen saturation, stimulating and paining contractions.

By the middle of the first stage of labor, when the contractions increase and become painful, “candle breathing” helps a lot. It's frequent shallow breathing, in which a short breath is taken through the nose, and exhaled through the mouth (as if we are blowing out a candle). As contractions intensify, breathing becomes more intense, but still remains very frequent. Breathing in this way should only be during a contraction; at the end of pain, the woman in labor makes deep breath and exhale, aligning the breath, and rest until the next contraction.

At the moment of full disclosure of the cervix, when the contractions become especially long and frequent, it is most effective to breathe in a "train". This breathing is an alternation of the previous techniques. At the beginning of the fight, the expectant mother uses breathing with her stomach, saving strength. As the pain intensifies, breathing quickens and at the peak of the contraction becomes as intense as possible. Then, as the contraction subsides, the woman in labor calms and evens out her breathing.

In the second stage of labor, when the fetus begins to move along birth canal, each contraction is accompanied by a false urge to defecate (desire to empty the intestines). This sensation is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the woman in labor needs to avoid premature ones and relax as much as possible, helping the baby to descend through the birth canal. To achieve this goal during the fight you need to breathe "dog". This is rapid, shallow mouth breathing, really reminiscent of a dog's breathing. When breathing "doggie" the diaphragm - the main abdominal muscle - is in continuous motion, which makes the attempt impossible. Breathing has the maximum analgesic and relaxing effect.

Magic touch

Another effective way non-drug pain relief in childbirth is massage. By stimulating certain points and zones on the body during contractions, the expectant mother can independently regulate the pain impulse, reducing the level of pain and relaxing.

The most "popular" massage area among women in labor is the lower back, or rather, the sacral region. The sacrum is a fixed connection of the vertebrae in the lower part of the spine. The sacral nerve plexus is located in this region of the spinal cord: ganglion, which innervates the uterus and other organs of the small pelvis. By stimulating the sacral zone (lower back in the middle) during the contraction, the woman in labor blocks the transmission nerve impulse thus reducing pain. Massage can be carried out with one or two hands, massaging the area with the pads and knuckles, the base of the fist, the base of the palm, inside palms or hand massager. Movements during the massage can be stroking, pressing, you can pat, pinch and even lightly tap the affected area. To on the skin sacral region there was no irritation, you can periodically lubricate it with cream or oil. If you haven’t stocked up on oil for massage, don’t be discouraged: ask the midwife for liquid vaseline oil, which is always in the maternity hospital.

During the fight, you can stimulate the protrusions pelvic bones on the sides of the abdomen. These bones should be treated in the same way as the sacral area. You can try different methods: squeeze, press and release, stroke, pinch. Choose the type of massage stimulation that most effectively reduces pain for you. This method is a kind of distraction that transfers the source of pain.

Periodically during the contraction, gently stroke the lower abdomen in a semicircle, the region of the fundus of the uterus (the most upper part). The same stroking movements can be made by moving the hands from the lateral protrusions of the pelvic bones along inguinal fold towards the perineum and back. These movements calm the woman in labor, help to relax and improve blood circulation in the uterine area,

The next massage option is most convenient to apply while lying on your side or sitting on the ball. Hold it down inner sides palms to inner surface hips. During the fight, move your hands with pressure, without lifting your palms - from the groin to the knees and back, In this area passes recurrent nerve, innervating pelvic organs. Massaging the inner surface of the thigh helps to reduce pain and relax as much as possible.

In partnership childbirth the assistant can constantly carry out a light relaxing massage of the whole body, avoiding only the area of \u200b\u200bthe chest, perineum and abdomen of the woman in labor. The touch of hands loved one soothes the expectant mother and helps to relax better.

Water as a helper

The main plus of aquatherapy is the relaxing and analgesic properties of water. In warm water, the contractions are felt softer, blood circulation improves, the woman in labor has the opportunity to relax and take a comfortable position of the body, she is less tired. Water eliminates the occurrence of such side factors of discomfort in childbirth as dry skin, increased sweating chills or feeling hot

Recently, many maternity hospitals have begun to use non-drug pain relief of contractions with the help of water. For childbirth with aquatherapy, special showers and a hydromassage tank are used, located in maternity ward. Premises for water procedures in the rodblok are disinfected in a special way. Of course, staying in water during childbirth without risk to the health of the mother and fetus is possible only under the supervision of a qualified medical specialist. When using a special bathroom, the expectant mother should fit in it entirely, being able to turn around and change the position of the body. The water temperature must not exceed normal temperature body (36.0°С-37.0°С) and not fall below 30.0°С. Next to the woman in labor (in the shower or near the massage bath) there should always be a birth partner or a maternity hospital specialist.

Unfortunately, this wonderful method of anesthesia can not always be used. Staying in a water tank during childbirth can be considered absolutely safe only as long as the baby and the uterine cavity are protected by a wall. After the rupture of the membranes, the last barrier between the sterile uterus and the non-sterile vagina disappears. After all, water through the vagina can penetrate the uterine cavity and cause infection. There are fewer restrictions for using the shower in childbirth: this method will have to be abandoned only if the doctor recommends bed rest to the woman in labor.

If the birth proceeds without complications, you can visit the shower quite often during the entire first stage of labor. This requires two conditions: the presence in the maternity block of a shower room equipped for women in labor, and the possibility of observing the expectant mother during water procedures. Shower cabins for women in labor are made open (without doors - for the possibility of medical observation), pallets with a "non-slip" coating are used, and convenient handrails are installed along the walls. During the entire stay in the shower next to the expectant mother, a midwife or doctor should be inseparable. Of course, this is possible only in the case of individual management of childbirth; however, in partner childbirth, the spouse of the woman in labor can become the "observer" and assistant.

An optimal analgesic and relaxing effect can be achieved using a jet of water, like an aqua massager. To do this, you need to take the shower head in your hand and, changing the water pressure from low to medium and even strong, water the stomach in a circular motion throughout the fight. If you have an assistant, you can ask him to massage the lower back and sacral area with a jet of water. Between contractions, it is worth making the pressure of the water weaker and direct the jet to the face, shoulders, chest and legs, achieving total relaxation. Ideal Temperature water for pain relief during childbirth 36-40 ° C; more low temperature acts on the nervous system excitingly, but too hot water may cause bleeding.

The birth of a child is the most wonderful event in a woman's life. Of course, the process preceding this event requires a lot of strength and patience from the expectant mother. But wait from childbirth torments and unbearable pain not worth it; childbirth is a rewarding job. And if a woman was preparing for childbirth, knows how to help herself and goes to give birth with a smile, this exciting event becomes a real holiday. And there is no place for pain on a holiday!

Elizaveta Novoselova, obstetrician-gynecologist, Moscow

Discussion

And it was easiest for me exactly as they told me to lie down - on my left side! Neither squatting, nor on all fours, nor walking helped, it was not only painful, but also very tiring.

Absolutely amateurish article, is purely theoretical. In maternity hospitals Russian Federation You simply will not be allowed to apply any of these "methods" to facilitate childbirth. When I took a certain position to relieve pain, my doctor quickly responded: "Who taught you that? Come on, I don't like it like that." That's it. And we all know how to read smart books, no need to plagiarize.

12/19/2009 00:54:10, Lucrezia Castro

Comment on the article "Pain relief in childbirth"

There are some labors with an epidural, although it was configured without. In childbirth, the doctor insisted on anesthesia, and in my case, after the introduction of anesthesia, labor activity did not weaken, contractions and attempts were the first with the epidural, if not she, I would have died of pain because the contractions were anesthetized, but ...

Discussion

I join the questions of the curious, congratulations or how :)))
I won’t tell you on the topic, I gave birth both times myself, but in terms of contractions, my body is such that I don’t feel anything until the very birth, so pain relief is not necessary, I wouldn’t miss it :)
The only thing is that they injected something for the second time (I don’t remember the names of medicines well). And the reaction of the child to this was definitely. IN currently find out if the child's problems are the result of all this. It is clear that no one will say for sure, and I am unlikely to have a third birth :) But if there were, I would not give anything to inject. Only if the reason is absolutely serious, and so - let everything be natural. IMHO, it takes much longer and more expensive to deal with the consequences than to endure the process of childbirth.
All, IMHO, of course.

For what purpose are you interested? Giving birth soon and I missed everything?))
The first ones I had were with an epidural, they did it late and badly. For my taste (and in my youth I myself did epidurals to other unfortunate people) doing this business during contractions is quite troublesome. It is necessary to fix the body motionless. If the marriage is a rod, then curl up and lie still - it can be problematic. I personally anesthetized one half of the body - the leg, the half-ass and part of the belly, the second half I continued to feel perfectly.
I was also let down by the fact that they immediately laid me down, added anesthetic to the catheter and fussed in every possible way, rather to no avail. My back hurt for a long time and severely at the puncture site.
The second time I was smarter, did not give up, walked to the last, managed quickly and without anesthesia.
Well, in general - you get to compare the first and second births, and this is not very correct. The first ones are longer and more complicated by default, well, most often it is.
I hope there will be my third birth) and I hope even faster than the second) I would run)

Discussion

A very non-trivial view of epidural anesthesia. All sorts of nonsense is written there, but the video clip itself is interesting. Take a look if you have time.

By the way, 16 hours of contractions in the first birth is practically the norm. If there was no stimulation in the first, the second will definitely go faster and easier. Although, it seems to me that psychological point second birth is always scarier, because you already know exactly what the pain will be.

having endured all the contractions with the first child, she gave birth to the second with an epidural - she is very satisfied, for the 3rd time they simply did not have time to deliver it, she gave birth 1 hour after she arrived at the maternity hospital.

contractions. medical questions. Pregnancy and childbirth. He brought a candle (some kind of painkiller) and said that if after 2 hours it does not help, then call him. no-shpa promotes contractions if childbirth. It has a relaxing effect on the muscles of the uterus, with ...

Discussion

I had VERY strong workouts during my second pregnancy. Starting from 36-37 weeks. Just very. Moreover, they also interfered with the tone. It was a horror. My mom had the same thing with her first pregnancy.
By the way, my childbirth began again like sweatpants and did not intensify for quite a long time. Up to 5 cm of opening, I was almost sure that these were sweatpants. But after 6 cm, the difference became noticeable.

Pregnancy in a woman's life is one of the most beautiful periods, remembered for a lifetime. Childbirth is the natural end of this period. Childbirth in the understanding of many women is associated with severe pain, everyone endures them differently. Quite often, women agree to anesthesia during childbirth due to huge amount negative childbirth experiences of other women. However, it should be understood that all births are individual, often, you can not resort to anesthesia. What is anesthesia during childbirth and when is it needed - we will learn from our article.

Is anesthesia necessary during childbirth?

The term "anesthesia" originally came to us from Greek literally has two meanings:

The inability of a person to feel anything;
Anesthesia for surgical purposes.

To date, anesthesia is widely used in the birth process. For some women in labor, doctors strongly recommend using this service. This is due to the fact that childbirth is a long process, and the body of the future mother is individual in its own way. Some women get so tired during contractions that they don't have the strength to push. To avoid this, women in labor agree to anesthesia in order to take a break from contractions for some time and not feel pain.

Anesthesia also has some placebo effect. Women who agreed to pain relief experience less fear of childbirth, i.e. Anesthesia also has a psychological aspect.

Anesthesia during childbirth can be either medical or non-pharmacological. We will talk about this below. Anyway, allowable dose medicines must be agreed with a specialist. In some cases, there are certain contraindications to this manipulation.

Be that as it may, agreeing to anesthesia, a woman must understand that the medicine administered to her will definitely get to the child, because anesthesia has both pluses and minuses. In addition, complete loss of sensation during childbirth is highly undesirable. Natural childbirth is always much better for the baby, but here the issue is already resolved on an individual basis. It is best to resort to anesthesia if there is an indication for this.

In some cases, anesthesia is necessary for medical reasons, namely:

High blood pressure in a woman in labor, a tendency to hypertension;
Preeclampsia of a pregnant woman, preeclampsia;
Cardiovascular diseases;
Violation of respiratory functions;
Diabetes mellitus in a woman in labor;
Incorrect position of the cervix;
Severe pain from the birth process in a woman, the inability to endure it;
Very large fruit;
Incorrect presentation of the future baby;
Explicitly expressed fear of the expectant mother before childbirth.

Depending on how the birth proceeds, the doctor decides whether to use anesthesia. There are several types of anesthesia, we will talk about them now.

medicines are administered strictly according to the doctor's indications, and non-drug methods to facilitate childbirth are available to every mother

Methods of anesthesia during childbirth

Anesthesia can be both natural (non-drug) and medicinal.

Non-drug methods of pain relief in childbirth

If the woman in labor feels well, tolerates contractions normally, then medical anesthesia is not used by the doctor. Here will be appropriate natural ways relieve pain and tension, namely:

Proper breathing during contractions and attempts;
Ability to relax between contractions, distraction;
Childbirth in water;
Contractions in correct posture convenient for their transfer;
Aromatherapy.

There are other ways to relax during the birth process, these include:

Back massage;
Hypnosis of a woman in labor;
Acupuncture;
Taking a warm bath.

Every woman herself knows best that in this moment it will be better for her. We would like to elaborate on the most effective methods of pain relief during natural childbirth.

Activity of the expectant mother during childbirth

During contractions, a woman should be moderately active: sudden movements are useless, but lying down is not very useful either. Doctors advise to perform lungs physical exercise to ease the pain. Useful slopes in different sides, circular movements of the pelvis, rolling from toe to heel. Many experts recommend using a fitball - contractions on it are the easiest to endure, and it is very useful for blood circulation.

Breathing exercises

Breathing during childbirth is the most effective method the most painless transfer of contractions. In addition, it is useful for the child - during childbirth, he may experience oxygen starvation. By using correct breathing you can minimize the pain and tune in to a positive experience. Breathing exercises you can master it yourself - at special courses for expectant mothers, or at home by watching a video on the Internet.

Massage

Expectant mothers will be told at the courses what points on the body there are, by acting on which you can reduce pain. They are located in the region of the lumbar and sacral spine. If the expectant mother goes to childbirth with her husband or other loved one, you can ask him to give a massage.

childbirth in water

There is also such a way of easy childbirth - this is childbirth in water. To date, this method causes a lot of controversy. But if you think that it is optimal for you, then enlist the support of an experienced midwife. warm water helps the woman in labor relax and concentrate on contractions.

The perinatal period of a baby's life is one of the most important. Childbirth and the first hours of a child's life leave a serious imprint on its further development.

Medical pain relief during childbirth

Anesthesia during childbirth often occurs with the help of drugs. Below we will talk about modern medications anesthesia.

Epidural anesthesia

Epidural and spinal anesthesia is used most often in cases of natural childbirth in a woman. The epidural acts on the area below the back, thereby blocking pain. It begins to act 10 to 20 minutes after administration.

Epidural anesthesia is anesthesia in the spine. How epidural anesthesia is done: the doctor inserts a catheter with medicine into the back area, through which the anesthetic drug enters. During the introduction of the medicine, the woman must lie still, otherwise there is a risk of getting in the wrong place. All manipulations are performed by an experienced anesthesiologist, after which he monitors the condition of the woman and decides on the need for a new dose of anesthesia.

This method has both advantages and disadvantages. The advantages include the following:

There is practically no risk to the baby;
The cardiovascular system is not exposed to the aggressive effects of the drug;
An anesthetic drug can be administered throughout the entire period of contractions, depending on the condition of the woman in labor.

Cons of epidural anesthesia:

Some women continue to feel pain;
The procedure for administering the drug through a catheter requires high professionalism, since it is quite difficult to perform;
An epidural cannot be administered to a woman in labor rapid labor, since its action begins after 20 minutes, which is why the question of whether everyone does it disappears by itself .;
After epidural anesthesia, the back sometimes hurts.

Among the types of anesthesia, epidural is one of the safest, there are no complications after it.

spinal anesthesia

Spinal anesthesia begins to act immediately, as soon as the drug is injected into the back of the woman in labor, blocking sensations below the chest. It works for an hour or two. In addition, for spinal anesthesia, the doctor uses a very thin needle, which is inserted into the localization area. cerebrospinal fluid. This type of anesthesia can also be used for caesarean section if strong medications are used.

Additionally, during this procedure, a catheter is inserted into a vein in a woman to avoid possible complications.

Many mothers may be concerned about how long such anesthesia works. The answer is: 2 to 4 hours. The epidural effect is 2 times less, but there are practically no consequences for the back with it.

Benefits of spinal anesthesia:

Absence of pain when the needle is inserted into the spine;
The fetus is not at risk;
The cost is lower than epidural anesthesia;
A woman sees everything, she has a clear consciousness;
Instant effect.

However, this procedure also has disadvantages:

After anesthesia in this way, a woman should lie down for several hours without getting up;
After a puncture, after a while, headaches are possible;
Possible pain symptoms in back;
development of hypotension.

Pudendal anesthesia

She is also called local anesthesia, since the doctor anesthetizes only the perineal area. A woman may not feel this, because this is done in a fight. The need for this anesthesia is caused by an episiotomy. Both for the expectant mother and for the baby, pudendal anesthesia is not harmful.

General anesthesia

General anesthesia is used during childbirth only in case of urgent need, and only for caesarean section. Indications for such a procedure may be sharp deterioration the condition of the child or mother, as well as uterine bleeding. The doctor injects the patient with medicine into a vein, after which the woman falls asleep.

Why is general anesthesia dangerous? The fact that it affects the fetus, causes its drowsiness and deterioration of blood supply, a negative effect on its nervous system and further physical development. However, this best method to save both the mother and her baby.

After a while, a woman may experience dizziness, nausea, vomiting, drowsiness, body pain, but these symptoms disappear the next day.

Inhalation anesthesia

This is an anesthesia during childbirth, which is used when the cervix is not ready for full disclosure, while the woman in labor experiences severe pain from contractions. She does not suppress birth process, the woman quickly regains consciousness. In addition, this method is the safest.

epidural and spinal anesthesia These and other methods have their pros and cons.

Postpartum pain relief

Often, doctors are faced with the fact that a woman who has given birth is in severe pain. What complications can occur after childbirth?

Cramps of the uterus caused by its contractions;
Pain in places of ruptures;
Inability to go to the toilet;
Pain in the chest area;
Incorrect attachment to the breast, provoking nipple cracks.

With the above symptoms, the doctor will offer to drink an anesthetic medicine, and apply a healing ointment to the site of tears or incisions. In other cases, pain rarely accompanies a woman, provided she follows the rules of hygiene.

Other methods of independent local anesthesia:

Take regular showers
Cooling compress on the perineal area (you can use a water bottle and store it in the freezer);
Do not make sudden movements;
Postpartum pads can be stored in the refrigerator to minimize pain.

Medications for pain relief

They are divided into several types:

Antispasmodics;
Non-narcotic analgesics;
Narcotic analgesics;
Analgesics;
Sedative drugs.

Antispasmodics

They relieve pain in parturient women well and contribute to the early opening of the cervix, thereby reducing the stage of contractions. Antispasmodics are indicated for young women in labor and aged women. There is no risk to the fetus in a woman. These include: no-shpa, papaverine, buscopan.

Non-narcotic analgesics

They have an analgesic and psychological effect, relieving anxiety in a woman in labor. These include analgin and tramadol.

Narcotic analgesics

Safe for the child, but for the mother they have a number of side effects:

Nausea, vomiting, dizziness;
Difficulty breathing;
Dramatically reduce blood pressure;
constipation;
Depression.

These include Pentazocine, Pethidine, Butorphanol, Promedol. The latter is the most effective in pain relief.

Analgesics

They block some of the pain sensations, the consciousness remains clear. have a lot negative consequences for the child and for the mother. This includes opioids and other pain medications.

Sedative drugs

Their action is more aimed at relieving anxiety in the expectant mother, unfortunately, they do not affect the fetus in the best way. The baby may have decreased blood pressure and increased heart rate, respiratory functions are disturbed. These include Diazepam, Droperidol, Thiopental.

Any painkillers analgesics carry certain risks for the baby and the expectant mother. However, their use in exceptional cases may be justified.

Pros and cons of anesthesia during childbirth

Anesthesia has pros and cons. To date, opinions regarding the importance of anesthesia during childbirth are radically divided. Consider the advantages of childbirth with anesthesia.

Anesthesia during childbirth: why for?

It's hard not to notice obvious benefits painkillers:

The opening of the cervix accelerates, and, accordingly, the time of contractions decreases;
The baby passes through the birth canal more successfully;
Relieve stress in a woman in labor;
Psychoprophylactic effect on fetal hypoxia.
The drug does not linger in the baby's body, the risk is minimal.

Despite the obvious advantages of anesthesia, there are still negative consequences.

Anesthesia during childbirth: why against?

Although the risk is minimal, it is still there:

Inaccuracy of drug administration;
Drowsiness and lethargy of the child;
Difficulty natural opening cervix, childbirth lasts longer;
Often, contractions stop, which is undesirable for the birth process;
Women in labor complain of pain in the head after anesthesia, nausea, body aches.

Whether to do anesthesia during childbirth or not - every woman has the right to decide for herself. You can often see on the forums positive reviews young mothers regarding pain relief. Many say that anesthesia during childbirth greatly facilitated contractions and the stage of attempts.

Unfortunately, at present all more women resort to childbirth under anesthesia for no apparent evidence, while not thinking about side effects. It is very important to listen to the opinion of the doctor and understand at what stage of childbirth it is done. In rapid labor, anesthesia is contraindicated, in difficult labor it is recommended.

How much does anesthesia cost in childbirth? The price of anesthesia varies depending on the method of anesthesia and the amount of medication.

Does anesthesia hurt? This question worries many expectant mothers. However, if the health of the unborn baby is on the scales, then this issue fades into the background. Childbirth is not only difficult for you, but also for the baby. Whatever the quality modern techniques anesthesia, natural childbirth is always preferable.

Fear of pain during childbirth is rooted in the soul of a woman from the very beginning, and even after giving birth once, she can continue to be afraid. Why it occurs is understandable, everyone says that there is nothing more painful than childbirth. Someone compares labor pain with 20 broken bones at once, some say it was the biggest pain of his life.

If you are expecting a baby, you, of course, do your best to set yourself up for positive. Thanks to the availability of information comes the understanding that it is natural process, which should not cause much pain. By the end of the term, you calm down and the desire to end the pregnancy becomes stronger than these fears. But the question of whether childbirth is facilitated still remains. Even the most self-confident person should have hope that if it suddenly hurts too much, they will help him.

Do they give painkillers during childbirth?

Sure to do easy childbirth and painless, moreover, analgesics during childbirth in one form or another are now used in almost 90% of women in labor. You can do it in such a way that a woman will simply oversleep them, and she will have to be woken up at the most crucial moment.

Pain medication during childbirth has even become a source of additional income for maternity hospitals; almost everywhere you can get this service for a fee (we are talking about epidural anesthesia). In the antenatal clinic, you can be given a list of things necessary for the maternity hospital, so far it may contain medications designed to ease contractions.

You now have plenty of chances to think over childbirth, although from the point of view of what is best for mother and child during physiological childbirth, a birth without drugs is, of course, preferable.

How to anesthetize childbirth

There are several options to make childbirth painless. They differ in efficiency and safety. Another question is whether it is necessary. Sometimes loss of pain sensitivity is vital. For example, if the contractions are strong, frequent, but ineffective, and the cervix does not open.

The following methods are used for this process:

Physiological. This is a relaxing massage of the lower back, calm music, special breathing techniques and exercises, bath and shower.
Spinal and - a special injection during childbirth in the spine with the introduction of drugs to spinal cord. The most reliable and modern method. Such an injection during childbirth begins to act literally after 5 minutes, completely relieving pain.
Other drugs are also used during childbirth, which are administered intramuscularly, intravenously and in other ways. These are mainly antispasmodics, narcotic analgesics and drugs that affect the central nervous system. Even nitrous oxide (an anesthetic) is used, which a woman breathes through a mask, independently adjusting the degree of anesthesia.
Acupuncture and other physiotherapeutic methods of influence. Not applicable in all hospitals.

It also happens: at the end of the second stage of labor for about 40 minutes - 1 hour there are very intense, frequent contractions, leading to full disclosure of the cervix. Fatigue, accumulated over the past hours, makes itself felt, appears strong feeling pressure on the bottom, the baby presses his head on the cervix and sacral plexus, the head is pressed tightly against the entrance to the small pelvis and there is very little left before the birth of the crumbs.

The woman who says a firm "no" to anything medical interventions, at this time it may simply break. It is at such moments that a woman in labor most often screams - do me a caesarean, do at least something, stop it! But right now it's too late to do anything. If a woman in labor is given a medicine that really relieves pain, the baby may have complications after birth, for example, respiratory depression.

And then the necessary injection is given as a placebo. For example, a no-shpa is introduced, which does not have any effect on the uterus at all. This injection is done only to calm the mother, while she will wait for his action - she will have time to give birth.

How to relieve pain during childbirth on your own

The severity of pain during childbirth largely depends on how the woman in labor perceives the birth act. If you resist contractions, tighten up, then your body quickly gets tired and you begin to feel pain. It often happens that a woman initially expects pain during childbirth and thereby provokes its appearance. This is a vicious circle - the more you resist contractions, the more stronger pain the stronger the pain, the more you pinch. The uterus is working hard, but the cervix cannot open - you do not let her do it with your fear.

The pain syndrome increases due to the accumulation of lactic acid in the muscles of the uterus and its resistance to itself: some muscles work to open, while others spasm and do not allow to open. Due to the fact that at present, almost all expectant mothers have the opportunity to attend childbirth preparation courses, and you have the opportunity to learn in advance how to anesthetize childbirth on your own.

In the courses, you will learn everything about special breathing and relaxation techniques in childbirth, about exercises that help, you will tune in to the fact that giving birth is not painful, and should not be painful. It’s good if you have a partner with you during childbirth, not necessarily a husband. Even your mother, aunt or girlfriend can act as an assistant during childbirth. She needs to go to these courses with you. Here they will teach you how to make a relaxing massage during childbirth, breathe with the woman in labor, support and guide her at the right moment.

Yes, childbirth cannot be completely painless. Unpleasant sensations of course they will. Partly on how much it will be unpleasant and painful for you, you can influence yourself. And remember that if you suddenly fail, there is alternative ways relieve pain, analgesics are used during childbirth, if you need it, they will help you.