Pain is the inevitable companion of childbirth. To a certain extent, it is necessary: by the nature of sensations, the course of contractions is monitored. In most cases, the pain is quite tolerable, but with complicated labor, it can be too severe, and then the question of anesthesia arises.
In order to reduce the painful sensations of women in labor, different methods are used: correct breathing, massage, taking a comfortable position during labor. All of these methods are taught to expectant mothers in childbirth preparation courses.
Indications for the use of drug pain relief during natural childbirth, not associated with a cesarean section - a large fetus, a narrow pelvis, too painful contractions, provoking restless behavior of the woman in labor.
The inhalation method is called autoanalgesia - self-analgesia: feeling pain, the woman in labor herself brings the mask to the respiratory organs.
In the first stage of labor, when the cervix is dilated, inhalation anesthesia is used. A mixture of nitrous oxide or other gaseous anesthetic substances - fluorothane, methoxyflurane, pentran - is supplied by means of an inhaler mask. These substances are quickly excreted from the body, hardly harm the child, but can cause dizziness and nausea.
Depending on which medicine and in what dose is used, the effect of anesthesia can last from 10 to 70 minutes.
Pain relievers can be given intramuscularly or intravenously. From the bloodstream of the woman in labor, medications can enter the child's body, which is still connected by the umbilical cord with the mother's body, and then the child's nervous system will suffer, possibly a violation of the respiratory function immediately after birth. For this reason, intravenous and intramuscular anesthesia, as a rule, is used after the birth of a child - for example, when it is necessary to remove parts of the placenta that have lingered in the uterus.
Most often, local or regional anesthesia is used during childbirth. In the first case, the drug is injected directly into the small area that needs to be anesthetized; with regional anesthesia, we are talking about a rather large part of the body. Local anesthesia is used, in particular, for sutures if perineal tears occur.
During childbirth, two types of regional anesthesia are used - epidural and spinal. The first involves injecting an anesthetic drug into the epidural space, located between the spinal cord lining and the outer wall of the spinal canal. At the same time, the sensitivity of the lower half of the body is lost, but the woman does not lose consciousness. With spinal anesthesia, the medication is injected with a thinner needle below the level of the spinal cord. Spinal anesthesia is considered less dangerous in terms of possible side effects.
Regional anesthesia is useful during labor, but not during the strenuous stage. Both epidural and spinal anesthesia threaten with a drop in pressure up to loss of consciousness, difficulty breathing, and neurological disorders.
Both types of regional anesthesia are contraindicated in neurological and orthopedic disorders in a woman in labor (for example, with curvature of the spine), in the presence of scars on the uterus and with low blood pressure.
