Medications to relieve pain during labor

Many women want to experience the naturalprocreation, others seek to get rid of the pain. But, most likely, most women want to do without strong painkillers and do not experience physical suffering. First of all, prioritize what exactly you want:

The more you want natural birth, the more likely that your desire will come true;
if you have a good understanding of the techniques that facilitate birth, you may not need painkillers;
if you trust the doctor and medical staff, hope for the help of your partner - this will also help you cope with the pain and unpredictability of the bouts.

Before all, it is still necessary to weigh the pros and cons of using medicines during childbirth:

Medications can almost or completely relieve you of birth pain.
Childbirth is often more painful than you expected.
Although today there are many new drugs andtechnique, the perfect way to abolish pain during childbirth. Thus, one should not expect a complete absence of pain from the beginning to the end of childbirth even when taking pain medications.
Medications and anesthesia can affect the coursechildbirth. For example, medications sometimes promote relaxation, which speeds the progress of labor, but often does the opposite - inhibit the development of labor and increase the need for other medical intervention.
When you ask for pain medication, it can not be brought to you right away. After taking medication, they also do not start immediately.
Because "there are no drugs that are knowingly safe foryet unborn child ", most doctors and midwives do not welcome unlimited consumption of potent drugs throughout all births and delivery.
The drugs you take directly or indirectly affect the fetus.
Specific effects of drugs depend on the typemedication, dose, dosage form and time of administration, individual reaction to this drug, and other factors. When you are given any medicine, doctors monitor negative effects and, if necessary, begin to take corrective measures.
Since the immature liver and kidney of the newbornnot being able to quickly metabolize and remove the medicine from the body, the effect of some drugs on the child is more prolonged than on the mother.
Analgesics and anesthesia are often used when painful intervention or surgery (forceps or episiotomy) is required, and is always used in cesarean section.

Ideally, if you can discuss with a doctor the properties of drugs used for pain relief, namely:

purpose and benefits of using this drug;
there are analogues and what can happen if you do not use this medicine;
the possibility of unwanted reaction of the drug to your body;
side effects that may arise from the action of this drug on the mother, fetus or development of childbirth.

Analyzing this information, you can doconscious choice, which will have the most positive impact, both on your condition and on the well-being of the child. However, the choice is not so simple. You must, with the help of a doctor, weigh the expected physical and psychological benefits of the given medication and the possible risk. The only factor that can not be predicted and controlled is the nature of the birth itself. When using medicines, it is reasonable to maintain flexibility. In most cases, the birth takes place without complications, and according to your desire can be carried out without medication. Sometimes births are much more difficult - some are extremely long and debilitating, and some may require the help of a doctor or a surgical operation, which increases pain. In such cases, the benefits of medication clearly outweigh the risks. Childbirth may be difficult, so antenatal care should include the study of essential medicines and circumstances when they should be used. Each medicine and anesthetic has its own characteristics and is suitable only in a certain phase or period of delivery. Some medicines should not be taken too early, as they can interfere with the development of childbirth. Others should be given only at an early stage, as they can have a dangerous effect on the newborn. With sufficient time, most of these medicines are removed from the child's body before delivery. Due to differences in the effects of medications, you may be offered one drug during the latent phase of labor and the other during the transitional phase or delivery. With the right selection, medications can partially or completely alleviate the pain and at the same time do not seriously damage the child's well-being and the progress of childbirth. Used during, delivery and delivery, medications cause either analgesia (pain relief) or anesthesia (loss of sensitivity). These drugs can also be classified as systemic medicines and local anesthetics. "System" means "acting on the whole organism". Systemic medicines are available in many forms (pills, liquids, candles). All of them enter the bloodstream and are carried everywhere, where the blood enters, ie, they act on all the systems of the body (hence the name). The desired effect is pain relief, but there may be other, undesirable effects. It can be sedative and hypnotic drugs, tranquilizers, narcotic analgesics, etc. As we have already mentioned, the use of this or that drug should be discussed in advance with the doctor. Since systemic medicines are carried throughout the body, they penetrate the placenta and through it into the body of the child, where they can exhibit side effects. The strength of these effects depends on the amount of the drug, the number of doses and the time between taking the last dose and giving birth to the baby. Another important factor is the fullness, health and reaction of the child during childbirth. The same amount of medication can have less effect on a healthy, full-term baby than on a premature, sick or injured child. Medications or their metabolites do not disappear completely from the blood of the child within a few days after birth, and during this whole time, small neuro-behavioral abnormalities persist. These deviations may be so weak that only professionals can detect them using very sensitive tests.

General analgesia and anesthesia

The term "general analgesia" refers to a decreasepain and sensitivity to it. General anesthesia is a complete loss of sensation and consciousness. For labor and delivery, general analgesia and anesthesia is achieved by inhaling a certain gas, which acts almost instantly. In fact, gas acts faster than any other form of synthetic medicine. The main difference between general analgesia and anesthesia is the gas concentration used (percentage of the drug in the air). Lower concentrations reduce sensitivity to pain, but do not remove it completely. The mother gives birth to a mask and uses it herself for analgesia, but an anesthesiologist always performs anesthesia. General anesthesia is rarely used during childbirth through natural ways, because the participation of the parturient in the process is required. General anesthesia is used in the following situations:

urgent cesarean section, when rapid loss of sensitivity is required;
in small or rural hospitals where they can not perform local anesthesia around the clock;
in those rare cases when epidural or spinal blockade can not be performed;
a woman is intolerant of local anesthesia.

In such circumstances, the advantages of a commonAnesthesia outweighs the risk. In other cases, local anesthesia is preferable. General anesthesia is carried out two-step. First, an intravenous injection is made for "anesthesia induction." This quickly leads the woman into a relaxed and semi-conscious state. Then they let her inhale the gas, which causes complete loss of consciousness. In the trachea of a woman in labor, a tube is inserted to keep the airways open and continue to inject gas. Since a person who is in an unconscious state may experience vomiting, the tube protects from inhaling vomit. Regional and local blockade causes a decrease or total loss of sensitivity (numbness) of a specific part of the body. The anesthetic is injected by a syringe into the area of a particular nerve; this blocks the transmission of nerve impulses. The main function of nerves is the transmission of sensations (including pain) to the brain and the control of the activity of muscles and organs. This function is weakened by local anesthesia. Small doses of anesthetic are relieved from pain and other sensations, without affecting the muscular control. At high doses, both sensations and the ability to use muscles disappear. Large doses are also more likely to affect your child. Other factors influence your reaction and the child's reaction: the choice of medication, the place of injection, the technique of administration, the individual reaction of the organism and the condition of the child during childbirth. Local anesthesia does not affect your mind. You do not start to "swim", do not become sleepy and diffuse, as in the case of systemic pain relievers. The difference between local and regional anesthesia is at the injection site. A local anesthetic is injected under the skin, into the muscle or cervix of the uterus. It blocks the sensitivity of a small area around the nerve endings. Thus, paracervical blockade leads to numbness of the cervix; blockade of the perineum makes this area insensitive. Regional anesthetics are injected into the lumbar region next to the spinal nerve roots and act on those parts of the body to which the nerve endings go (in small areas, for example, the abdomen and lower back, or the whole body below the thorax). The regional blockade provides anesthesia for much larger areas than local anesthesia, using less medication. Spinal, saddle, epidural and caudal blockades are types of regional anesthesia. The purpose of anesthesia is to provide good analgesia without adverse side effects. In recent years, anesthesiologists have developed a technique called regional analgesia (mild epidural anesthesia or segmental blockade), which reduces pain, but does not completely remove sensitivity. Due to this, fewer side effects are observed than with standard regional anesthesia. To achieve analgesia, rather than complete anesthesia, the doctor uses a lower concentration of anesthetic. Another recently proposed method is to administer a combination of anesthetic with a small dose of the drug. But even with the modern development of anesthesia technology, there is a risk of side effects for the mother or child. We advise you to read: