Medications for pain relief during labor
Many women want to experience the naturalprocreation, others seek to get rid of the pain. But, probably, the majority of women are willing to do without powerful painkillers and do not experience physical suffering.
First and foremost, prioritize what you want:
- the more you want a natural birth, the more likely that your wish will come true;
- if you have learned well the techniques facilitating the delivery, pain relievers you may not be needed;
- if you trust the doctor and medical staff, hoping to help your partner - it will also help you cope with the pain and unpredictability of labor.
Previously should still weigh the "pros" and "cons" of the use of medications during labor:
- Medicines are almost or completely rid you of the pain of labor.
- Childbirth is often more painful than you expected.
- Although today there are many new drugs andtechnology, the perfect way to undo the pain of childbirth is not. Thus, one should not expect a complete absence of pain from the beginning to the end even when receiving delivery of pain medications.
- Medication and anesthesia can affect the coursedelivery. For example, drugs are sometimes promote relaxation, which speeds up the progress of labor, but often do the exact opposite - slow down the development of labor and increase the need for other medical intervention.
- When you ask for pain medication, it can bring you at once. After receiving medications also begin to act immediately.
- Since "no drugs, known safe forunborn child ", most doctors and midwives do not welcome an unlimited consumption of hard drugs throughout the labor and delivery.
- you are taking medications directly or indirectly affect the fetus.
- Specific effects of medicine depends on the type ofmedicament dose, dosage form, and the reception time, individual response to the drug and other factors. When you are given any medicine, doctors monitor the negative effects and begin to take steps to remedy if necessary.
- As the immature liver and kidneys of the newbornunable to quickly metabolize and remove the drug from the body, the effect of certain drugs on the baby is longer than the mother.
- Pain medications and anesthesia are often used when required painful surgery or intervention (forceps or episiotomy), and is always used for caesarean section.
Ideally, if you can discuss with your doctor the properties of the drugs used for pain relief, namely:
- objects and advantages of the use of this drug;
- is there any analogues and what can happen if you do not use this medicine;
- possible adverse reactions of the drug on your body;
- side effects that may arise from the effects of this drug on the mother, the fetus or the development of labor.
After analyzing this information, you can make an informed choice that will have the most positive impact, both on your condition, and the child's well-being.
However, the choice is not so simple. You need with the help of a doctor to weigh the expected physical and psychological benefits of this medication and the potential risk.
The only factor that can not bepredict and control, - the very nature of childbirth. reasonable to retain flexibility in the use of medicines. Most deliveries take place without complications, and according to your wishes can be carried out without medication. Sometimes birth is much more difficult - some very long and exhausting, and some may require the help of a doctor or a surgery that increases the pain. In such cases the use of drugs clearly outweighs the risk. Childbirth can be difficult, so prenatal training should include a study of essential drugs and the circumstances when they should be used.
Each drug and anesthetic have their owncharacteristics and are suitable only in a particular phase or stage of labor. Certain medicines should not be taken too early, because they might interfere with the development of the birth. Other should only be given at an early stage, since they can have a dangerous impact on the newborn. With enough time, most of these drugs is derived from the child's body before birth. Because of differences in the action of drugs you may be offered a drug during the latent phase of labor, and the other - during the transition phase or delivery. With proper selection of drugs may partially or completely relieve the pain and at the same time did not seriously damage the child's well-being and progress of labor.
Used at the time of labor and deliverymedications or cause analgesia (pain relief), or anesthesia (numbness). These drugs may also be classified as drugs, and systemic local anesthetics.
"System" - it means "acting on the wholebody. " Systemic medications are available in many forms (pills, liquid, candles). They all enter the bloodstream and spread throughout, which enters the blood, t. e. apply to all systems of the body (hence the name). The desired effect - the pain relief, but may be other adverse effects. It can be sedative and hypnotic drugs, tranquilizers, narcotic analgesics, and so on. D. As we have said, the use of a particular drug should be discussed in advance with your doctor.
Since systemic medications are carried onthroughout the body, they penetrate into and through the placenta to the baby, which can manifest side effects. The strength of these effects depends on the amount of the drug, the number of doses and the time between receiving the last dose and childbirth. Another important factor is the full-term, health and the reaction of the child during birth. The same amount of the drug may have a lesser effect on the healthy, full-term baby than premature, sick or injured.
Drugs or metabolites thereof are not disappearcompletely out of the baby's blood within a few days after birth, and during all that time saved a small neuro-behavioral abnormalities. These deviations may be so weak that they can only be detected by professionals using very sensitive tests.
General anesthesia and analgesia
The term "total analgesia" refers to a decrease inand pain sensitivity thereto. General anesthesia - the total loss of sensation and consciousness. For labor and delivery analgesia and general anesthesia is achieved by inhalation of a particular gas, which acts almost instantaneously. In fact, the gas is faster than any other form of synthetic drugs.
The main difference between the total and analgesiaanesthesia - the used gas concentration (percentage of drug in the air). Lower concentrations reduce sensitivity to pain, but do not remove it completely. Woman in labor sometimes she takes the mask and uses her own for analgesia, but general anesthesia always carries an anesthesiologist. General anesthesia is rarely used during childbirth through natural ways, as mothers need to participate in the process. General anesthesia is used in the following situations:
- an emergency caesarean section, when you want a quick loss of sensation;
- in small or rural hospitals, where they can not perform a local anesthetic around the clock;
- in those rare cases when it can not be performed epidural or spinal block;
- woman intolerance to local anesthetics.
In such circumstances, the benefits outweigh the risks of general anesthesia. In other cases, local anesthesia is preferred.
General anesthesia is performed in two stages. First is the intravenous injection for the "induction of anesthesia." This quickly leads a woman into a relaxed and semiconscious state. Then it is allowed to breathe the gas that causes a complete loss of consciousness. tube inserted into the trachea mothers to keep the airway open and to continue to introduce gas. As a person who is unconscious, vomiting, tube prevents inhalation of vomit can occur.
Regional and local blockade causesreduction or complete loss of feeling (stiff) to certain parts of the body. The anesthetic was injected into a specific area of the nerve; it blocks the transmission of nerve impulses. The main function of nerves - the transfer of sensations (including pain) in the brain and control muscle activity and organs. This function is weakened local anesthesia. Small doses of the anesthetic released from pain and other sensations, without affecting muscle control. At high doses disappear and feelings and the ability to use the muscles. Large doses also affect your child is more likely. On your child's reaction and the reaction is also influenced by other factors: the choice of medication, injection site, injection technique, the individual reaction of the body and the condition of the child during birth. Local anesthesia does not affect your mind. You do not begin to "float", do not get sleepy and scattered, as in the case of systemic analgesics.
The distinction between local and regional anesthesiaIt is the site of injection. Local anesthetic injected under the skin, in a muscle or cervix. It blocks the sensitivity of a small area around the nerve endings. So, paracervical blockade leads to cervical numbness; perineal blockade makes insensitive this area. Regional anesthetics are administered in the lumbar region, close to the roots of spinal nerves and act on those parts of the body, which leave the nerves (in small areas such as the abdomen and the lower back or the entire body below the rib cage).
Regional block provides analgesiamuch larger areas than local anesthesia, using less medication. Cerebrospinal, saddle, and epidural caudal blockade are types of regional anesthesia.
The purpose of anesthesia - provide good pain reliefwithout adverse side effects. In recent years, anesthesiologists have developed a technique called regional analgesia (epidural or light segmental blockage) that reduces pain, but does not remove completely the sensitivity. Because of this there are fewer side effects than standard regional anesthesia. To achieve analgesia and anesthesia is not full, the doctor uses a lower concentration of anesthetic. Another method recently proposed - to administer a combination of anesthetic with a small dose of the drug. But even with the modern development of the art of anesthesia is a risk of side effects for the mother or child.</ P>