Pregnancy is a dream come true of all couples. The first time mothers are filled with apprehension and innumerable questions. They get their queries solved by consulting their elders and peers and now newsgroups. They develop misconceptions and fears regarding pregnancy and labor.
The perception of pain during labor and delivery varies between individuals. Specially, the first-time mothers need a proper antenatal counselling regarding good nutritious diet, antenatal exercises and physiology of labor pains. Here we shall only be dealing with labor & delivery.
Epidural anaesthesia is an advance in pain management during labor, which ensures that a pregnant woman has a comfortable labor. It is a regional anaesthesia in which an anaesthetic drug is injected near the spinal cord in the spinal canal.
» » Areas affected
It numbs the body below the waist, but the movements are not impaired.
Time of anaesthesia
It is administered when the patient is in active labor.
It can be given as a single injection or in multiple doses through a special epidural catheter by a skilled anaesthetist.
» » Advantages
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Services Provided
Almost complete relief from pain with the patient being mobile
No postpartum headache as in spinal anaesthesia
Mother is conscious and alert throughout the labor
An instrumental delivery can be performed under the same anaesthesia, if need arises
If the patient has to be taken for caesarean section, the effect can be topped up through the epidural catheter.
» » Disadvantages
Sudden drop in the blood pressure
Because of pelvic floor relaxation, baby’s head may not rotate and forceps application may be required.
Slight increased rate of instrumental and caesarean deliveries.
Pregnancy and child birth is the most precious gift for women given by God. The nine month of pregnancy are full of dreams and plannings. The only one thing which makes a pregnant lady curious, anxious and fearful is the pain during delivery. During the antenatal visits a sound obstetrician always counsel the pregnant lady and by the time she attains the full term is acquitted with the normal course of labor pain and the obtetrician even the ways to get rid or minimize the pain during the birth process.
Though none of the methods are free from disadvantages when applied at the time of labor, so it is necesary to prepare and start the methods to have pain free delivery since the time of conceiving. Before proceeding to recommend some methods of painful delivery, it is better to know the physiology behind this pain.
During the labor or delivery there is stretching of the cervix, uterus, vagina and perineum leading to stretching of nerve fibres supplying them, thus causing pain. The soft tissues are squeezed due to fetal skull and add pain. This is the reason why pain subsides and decrease in intensity after the head comes out.
» » Methods of painless delivery
There are various methods to have a pain less delivery or delivery with minimal pain but each methods have some advantages associated with some disadvantages. These methods are-
» » Yoga for pregnancy
There are some yoga and pranayamas and mudras which should be done during pregnancy and these has been proved to be effective for a painless delivery. The two very important pranayama and yoga for painless delivery are Bhramari Pranayama which tunes neuroendocrine system of our body and helps in releiving pain during delivery. Other yogasana is Baddhakonasana which provides strength to reproductive organs and muscles active during delivery and makes them more flexible thus reduces the pain. Though some may be anxious and unable to perform yogasana, for them mudras are easier and equally effective which stimulate the body and positively affect reproductive organs. These yoga and mudras or pranayama should be done during the pregnancy period for a safe, painless and uneventful delivery.
» » Hypnosis for painless delivery
Hypnosis, is a mind body techniques, It is a process of allowing the mind and body to relax deeply. In hypnosis, suggestions are given, which helps in interpreting contractions as a sensation that is allowed and not oppose them. A person who feels “this is excruciating and extremely painful” has a very different experience from someone who says “this strong sensation means my cervix is opening and now every force can make me a mother of a cute baby.”
Many believe hypnosis means being controlled by someone else. This isn’t true as the first premise of this art is that all hypnosis is self-hypnosis. No one can force you to do or believe anything that you don’t agree with.
» » Water birthing a method for painless delivery
Water birth is a type of hydrotherapy for pain management during delivery. It is very much effective for back pain. In this method the woman is made to sit in a tub of warm water for the delivery. The warmth significantly relieves the pain in the fist stage of delivery while cervix of the uterus opens gradually. The buoyancy of the mother and baby allow for a gravitational pull which not only opens up the pelvis, but also allows the baby to descend more easily. Moreover, due to the documented
relaxing effects of water, this method is sometimes associated with a decrease in the intensity of contractions, and is thus thought to slow down labour.
Disadvantage of water birthing is one that there is a chance of infection though water and the other disadvantage is the risk of water inhalation by the baby.
» » Epidural anaethesia for painless delivery
Epidural anaesthsia is the most common method applied for combating pain during delivery. It is given in the form of injection at the lower spine intermittently. The pregnant lady remain conscious and aware of the activities going on, but there is a numbness at the pelvic region. The extra advantage of epidural anaesthesia is that it makes easy for instrumental delivery if any forceps are required and even is sufficient anaesthesia is an urgent ceaserean section is required.
Epidural analgesia is given when labour is well established and the cervix is at least 3 to 4 cm wide.
The biggest disadvantage is that in some case there is sudden drop in blood pressure and patient may feel giddiness and there may also be a problem in rotation of fetal head leading to more instrumental delivery.
» » Epidural anaethesia for painless delivery
Promedolum or sedatives are sometimes used and in case of unbearable pain morphine or its derivative like pethidine is used but these are not recommended as they affect the baby or in case it is required seriously then it should be stopped two to three hours before birth.
Thus there are several methods when the continuation of the pleasure feeling of being a mother is maintained with painless, harmless and uneventful delivery.