Can childbirth analgesia be used or not?
”Husband, it hurts too much to have a baby, I’m scared ……”
”Doctor, is it very painful and painful to have a baby? Can it not be so painful…”
The process of giving birth to a baby is painful and beautiful, the pain brings a sense of suffocation as if deep under the sea, but when you hear the baby’s wow sound, it is like seeing a rainbow after the rain, the happiness of seeing the warm sun in winter. This is the birth of a life, but also the birth of a great mother.
It is probably what most mothers want to reduce the pain of childbirth while they are expecting a new baby. Let me tell you more about “labor analgesia”!
In order to reduce labor pain and improve the quality of labor, labor analgesia can only be performed on the premise of ensuring the safety of mother and child and improving the quality of medical services. Of course, the most important prerequisite is that the mother voluntarily accepts labor analgesia!
How to determine if a woman can have labor analgesia
A systematic assessment of the mother will be conducted before the delivery analgesia, which generally includes
Medical history
History of the woman’s current medical history, past history, history of anesthesia, history of drug allergies, whether she is taking anticoagulants, comorbidities, coexisting conditions, etc.
Anesthetic assessment
Basic vital signs, general condition, presence of contraindications such as difficult airway, abnormalities of the spinal space, infected foci at the puncture site, or occupying lesions.
Related laboratory tests
Routine blood tests, coagulation function, and special laboratory tests if there are comorbidities or abnormalities.
Contraindications to labor analgesia
The woman refuses to have labor analgesia.
Vaginal delivery cannot be performed after assessment by obstetrician.
Contraindications to intradural block: such as intracranial hypertension, abnormal coagulation, puncture site and systemic infection, and conditions affecting the puncture operation.
What are the complications of labor analgesia?
When it comes to labor analgesia, the main concern of mothers and their families is whether it will affect the health of the mother and child. In fact, the implementation of labor analgesia is based on the highest principle of maternal and fetal safety, so serious life-threatening complications are rare, but there are some minor complications.
Maternal
The complications that may occur during labor analgesia are hypotension, mild headache, etc. These adverse effects are generally manifested in the effect on the labor process and on the blood supply to the placenta, which can prolong the labor process and increase the chance of surgically assisted delivery. In addition, labor analgesia does not reduce the incidence of obstructed labor.
Fetus
Epidural analgesia and anesthesia are safe for the fetus. The dose of labor analgesia is very low, only 1/20 to 1/10 of the dose used for cesarean section, so the chance of it entering the mother’s bloodstream and passing through the placenta is minimal, and it has no effect on the fetus.
Intradural labor analgesia (including continuous epidural analgesia and combined lumbar-rigid analgesia) is preferred for labor analgesia. When there are contraindications to intraspinal analgesia, intravenous labor analgesia can be chosen according to hospital conditions if the mother strongly requests it, but monitoring and management must be strengthened to prevent dangerous situations.
Although labor analgesia can largely reduce maternal stress, its popularity is not high in China.
The main reason is that there is no additional national fee for labor analgesia, which is charged according to the standard of epidural anesthesia. Whereas it only takes half an hour to do a cesarean section under continuous epidural anesthesia, labor analgesia takes more than ten hours. Under this premise, the charges cannot be solved, and the income is not enough to cover the expenses, so naturally it cannot be promoted.
Secondly, labor analgesia requires a large number of anesthesiologists, and at present, the overall number of hospital anesthesiologists is small, so it is difficult for hospitals to spare manpower and energy to carry out the work of labor analgesia.