All women know (someone is rumored, and someone from their own experience) that childbirth is a very painful process. But medicine does not stand still, and every day childbirth with epidural anesthesia is gaining popularity. What it is? Now let's figure it out. From this material, you can find out what are the indications and contraindications for epidural anesthesia during childbirth? The consequences and reviews of women will also be considered in the article.
Is epidural anesthesia?
Anesthesia, designed to temporarily anesthetize the contractions. The drug is injected into the epidural space (in the lumbar region). He, in turn, blocks the pain. But only for the time of fights.
The dosage is specially calculated so that by sensations all sensations return and childbirth passes without complications. During the action of anesthesia, a woman can calmly walk or rest before the upcoming birth. A quantity of medication is administered so that the pregnant woman is conscious, but does not feel pain. With such anesthesia, a cesarean section is done, that is, the mother is conscious at the time of the birth of the child. She can see her baby right away, from the first seconds of his life.
When is it free and when is it paid?
Epidural anesthesia during childbirth is done free of charge only for medical reasons. If a woman asks for anesthesia for no reason, then she will have to pay.
What drugs are used?
For pain relief of contractions or for cesarean section, epidural anesthesia can be done with several drugs. Their list is small:
- "Trimekain." It is not used independently, it is combined with anesthesia. The effect of anesthesia occurs rather quickly, but does not last very long (within an hour).
- Dikain. It is more suitable for cesarean section. The anesthesia process lasts up to three hours. The drug begins to act 30 minutes after administration. The tool is quite dangerous. With an incorrectly calculated dose, poisoning of the body is possible.
- Chlorprocaine. The effect of the drug is the same as that of Trimekain, but there is no need for additional anesthesia. It goes as an independent tool.
- "Bupivacaine." It is popular for pain relief during childbirth. The action after administration of the drug occurs quickly enough, and the duration is five hours. Its plus does not adversely affect the course of labor. Relaxes the uterus.
- Mepivacaine. The danger is that it can penetrate the blood of a child. Typically, the effect of anesthesia is not more than 1.5 hours.
- Prilocaine. The action is similar to Mepivacaine, but it can also reduce the amount of hemoglobin in the blood of the mother and baby.
Before prescribing epidural anesthesia for natural births, the doctor must weigh the pros and cons. The specialist should also ask the patient if any medications are being taken, if there is an allergic reaction, and so on. To minimize the risk of anesthesia for a woman in labor and her fetus.
Administration options
Depending on what the anesthesia is done for, the drug can be administered in different doses. If for caesarean section, then the entire dose is administered once. In this case, the vessels of the legs expand, and the woman will not be able to temporarily walk. But this is not required in this procedure. But it will not be necessary to introduce an additional drug. And it will be enough for the duration of the operation.
If for pain relief of contractions, then it is better to administer the drug in parts so that the woman can move without restrictions. It is believed that childbirth with epidural anesthesia does not pose any danger to either the mother or the baby.
How does an epidural anesthesia procedure work?
The process of anesthesia:
- The woman in labor should be in a comfortable position. It is important. Since in the process of introducing anesthesia, the woman should be motionless. Otherwise, complications may arise. And the doctor needs good access to the treated area. Usually the procedure is performed sitting or lying on its side. The back should be bare.
- Before the introduction of the drug, the doctor treats the area with a disinfectant solution. And then the area where the drug for epidural anesthesia is administered is anesthetized. Usually, Lidocaine is used for pain relief.
- A catheter is inserted into the selected and anesthetized area, through which the drug will be administered. The catheter is removed only after the need to administer the anesthetic disappears. The entire dose is not administered at once. So that a woman can be conscious. Important. If before the introduction of the catheter, the woman feels the approach of the contractions, this should be reported to the doctor. Otherwise, involuntary movement will ruin the procedure and may cause pain.
- Usually, the medicine begins to act in about 20 minutes. But it depends on which remedy is chosen. The catheter is removed from the back after delivery. After this, the woman in labor should spend three hours motionless.
Do epidural anesthesia during childbirth? This is mainly decided by the doctor. But if the woman in labor believes that she is no longer able to endure pain, and the birth itself is not yet close, then the contractions can anesthetize. But you need to remember that then the procedure will be paid.
If, after the first dose is administered, a woman begins to feel discomfort: nausea, dizziness, and the like, you should immediately inform your doctor. Perhaps the selected drug is not suitable.
Not all doctors welcome childbirth with epidural anesthesia, since anesthesia affects the opening of the cervix, and also makes the birth process not so active. A sluggish birth can harm both the baby and mother.
Indications for epidural anesthesia
Having a baby is a very unpredictable process. Even if the pregnancy is proceeding normally, this does not guarantee normal labor. What are the indications for epidural anesthesia during childbirth? The doctor may prescribe it in the following cases:
- Childbirth is premature. It is with them that the most painful fights are. The body is not yet ready for the birth of a child. The pelvic bones are not apart, the muscles and birth canal are not prepared. In this case, anesthesia will benefit. It helps a woman not to lose a lot of energy on the fights themselves. And at the time of the attempt, the woman in labor can make every effort to help the baby be born. The muscles after administration of the drug are in a relaxed state, so it will be easier for the child to move through the birth canal.
- With prolonged and painful contractions, especially if the opening of the cervix is very slow. With this course of childbirth, the mother may be left completely without strength to the appearance of attempts. Sometimes the process with contractions can last more than a day - this is not normal, but this occurs. Thanks to epidural anesthesia, a woman in labor can sleep and regain her strength. And muscle relaxation will help the cervix open faster.
- Epidural anesthesia during labor has been proven to help lower and normalize blood pressure. Therefore, it is recommended for mothers with high blood pressure.
- It is used for cesarean section (multiple pregnancy, large fetus, or due to health reasons it is not allowed to give birth independently), when general anesthesia is prohibited.
- With the discoordination of childbirth, when contractions are not regular, the uterus opens sluggishly. Then anesthesia helps to smooth the birth process. Or maybe the pregnant woman agreed in advance with the doctor about epidural anesthesia as needed. Thanks to the drug, the expectant mother has the opportunity to save strength in labor, as well as to see the birth of a baby with a cesarean section.
Contraindications to anesthesia
But, unfortunately, not everything is so smooth with epidural anesthesia during childbirth. Before prescribing it, the doctor should check the woman in labor for contraindications.
- intolerance to the components that make up the drug;
- unconsciousness caused by trauma;
- skin diseases in the back where the catheter is to be inserted;
- allergy;
- problems with the spine (for example, a curvature that worsened during gestation). This will interfere with the normal catheter insertion;
- if the woman in labor is a minor;
- with overweight pregnant;
- when the pressure is very low (the drug will lower it even more);
- a woman in labor is severely exhausted (low weight, loss of strength, and so on);
- if there are problems with the mental state of the pregnant woman;
- problems with blood vessels and heart;
- if there is bleeding from the uterus;
- clotting problems or blood poisoning;
- the pregnant woman herself refused anesthesia, although she was prescribed by a doctor. Until consent is obtained, the drug is not eligible to enter.
The last point is extremely important for every pregnant woman who decides to give birth with epidural anesthesia. Note that for any indications, the doctor will not be able to start using painkillers until the consent of the woman in labor is obtained.
Epidural anesthesia during childbirth. Reviews and Consequences
Any medical intervention has its consequences, both positive and negative. Epidural anesthesia is no exception. What should be expected after such anesthesia:
- A not very qualified doctor may just get caught or the woman in labor will accidentally move at the moment of catheter insertion. Then the tip can damage the vein or nerve ending. The consequences are not always predictable (from headaches to paralysis). Therefore, it is extremely important to look at the doctor and behave exactly as he advises during the introduction of the catheter.
- Temporary numbness of the tongue and nausea.
- If the pregnant woman does not know that she is allergic to the drug, and the corresponding analysis was not done in the hospital, then anaphylactic shock is possible.
- There may be pain at the injection site of the catheter, pain is tolerable, but unpleasant and lasts more than one day.
- If pain relief during childbirth (epidural anesthesia is meant) was not carried out correctly (dosage is exceeded), then numbness of the legs is possible. This will stop after the action of the drug.
- The wrong dose, in a smaller direction, will not give the desired analgesia effect. But this may be due to the personality of the body, even with the right dose. In this case, it is impossible to administer the medicine again, poisoning of the body may occur.
- Headache and discoordination of movements.
- Respiratory failure and decreased pressure.
- There may be problems with the discharge of urine.
In the reviews, the women write that it was impossible for them to endure the fight, it was incredibly painful. Epidural anesthesia during childbirth is usually done at the request of the patient. During the birth of a child, as they say, a woman sometimes just does not control herself. But before deciding on anesthesia, you need to soberly assess the situation. This is a very important point. Women in labor say that it’s worth thinking well, maybe you can do without interventions. Otherwise, the various consequences described above may occur.
The opinion of doctors
In the doctors' comments about epidural anesthesia during childbirth, they write the following: “It is only necessary to carry out such a procedure. Otherwise, you can harm the woman in childbirth or the baby. In another case, it is worth abandoning it. " In the process of childbirth, it is very important to listen carefully to the doctor.
How does anesthesia affect a baby?
After the introduction of the drug, the mother should feel relief. But if side effects begin to manifest in the woman in labor, then they can also affect the baby. Shortness of breath will reduce the amount of air that enters the fetus. Oxygen starvation may begin.
Also, due to the action of the medicine, the baby will move more slowly along the birth canal. It could hurt him. You may need the help of a doctor to extract the fetus from the vagina. This is another risk of birth injury.
The best analogue of anesthesia is proper preparation for childbirth. Good and positive attitude. It is possible and necessary to do gymnastics, which will help the baby to be born faster. Only natural childbirth, with the sensation of all pains, will bring mom real joy at the first meeting with the baby.
Epidural anesthesia during childbirth. "Pros and cons"
Now we will consider the main pros and cons of such anesthesia during childbirth.
Advantages of anesthesia:
- Anesthesia relieves pain during contractions, allows the pregnant woman to relax and prepare for childbirth with a protracted labor process.
- Lowers blood pressure, with it, women with hypertension can give birth to a baby without a cesarean section.
Cons of epidural anesthesia during childbirth:
- An unqualified doctor may get caught or a woman may accidentally move when a catheter is inserted. As a result, there will be complications.
- Side effects are possible.
- It is believed that the mother does not feel her baby after anesthesia. Therefore, the birth of a child does not bring so much joy as a natural birth.
Advice
After familiarizing yourself with all the indications and contraindications, as well as evaluating all the positive and negative aspects of the procedure, we can conclude for ourselves whether it is worth risking the health of the child (and ours) in order to facilitate the birth process.
If the procedure is prescribed by a doctor, then it is better to agree. Epidural anesthesia during childbirth is not in vain has become so widespread. She really helps if something goes wrong. And while the child practically does not suffer.
It is important to take the procedure seriously. If it is known in advance that the doctor will prescribe such anesthesia, be sure to choose a good anesthesiologist (if allowed). Discuss everything to the smallest subtleties with a specialist. Especially how to behave during the procedure. And most importantly, if there are any contraindications. A doctor must know about them.