For more than a century and a half, the search has been on to find ways to make labor awake and pain-free. Many factors influence the level of pain experienced during labor: maternal psychological preparation, emotional support during labor, maternal experience with labor, abnormal fetal position, and the use of contractions. Childbirth and severe pain go hand in hand, often more than expected, as reported in the McMill Pain Questionnaire in the United States: labor pain is the most severe pain a woman can experience, and is typically worse than toothache, back pain, and pain from deep lacerations. A survey reported that 60% of first-time mothers described contractions as “unbearable, unbearable and extremely painful” during the first stage of labor. As early as in the 18th century, Queen Victoria of England successfully applied laughing gas for painless childbirth, and painless childbirth in western countries has become quite popular, with 85% of women in the United States choosing painless childbirth and up to 90% in the United Kingdom, while less than 1% of women in China practice painless childbirth. With the improvement of living standard and the implementation of China’s family planning policy, most women only have one child, they do not want to suffer the pain of childbirth, cannot bear the shock of turning to cesarean section during labor, cannot accept the possible lack of oxygen and damage to the fetus during the long labor process, and resolutely choose to deliver by cesarean section. In fact, it is no longer a problem for us to let women enjoy painless delivery technically, what we need is to promote it vigorously. The implementation of labor analgesia solves the problem of pain, increases the courage and confidence of the mother, improves the rate of vaginal delivery, and helps to improve the quality of the perinatal period and the physical and mental health of the mother through the correct implementation of analgesia during labor. At present, the introduction of painless childbirth in the media and online is one-sided and lack of science.
1.What is painless childbirth?
What we usually call “painless childbirth” is actually called “labor analgesia” in medical science. It is the use of various methods to reduce or even eliminate pain during childbirth. Anesthetics or analgesics are widely used in hospitals to achieve pain relief, and the common clinical methods are epidural block analgesia (anesthetic injection) and laughing gas analgesia.
The painless delivery can reduce the fear of labor and postpartum burnout, so that the mother in the most need to rest, the longest time of the first labor to get “rest and recuperation”, to the final stage of labor will have more energy.
2. Is painless delivery really painless?
Ropivacaine has a good “separation anesthetic effect”, which only blocks your pain sensation and does not affect muscle strength, so you can move normally; sufentanil is the strongest analgesic drug with the least side effects. It is possible to have a reduced or completely painless delivery, depending on the mother’s request and response. We recommend that preserving the sensation of mild uterine contractions is the best way to have a painless delivery. According to statistics, 85% of mothers have no pain at all after a painless delivery, and 12% of mothers have an appropriate degree of relief.
3. Can all mothers in normal labor choose to have a painless delivery?
Not all mothers who want to have a normal delivery are suitable for labor analgesia, for example, some mothers have skin infection on their backs, or suffer from sepsis or blood clotting disorders, or have had back injury or spinal surgery, which are not suitable for labor analgesia. There are also mothers with obstetric anomalies such as abnormal birth canal, fetal malposition, placenta praevia, poor fetal heartbeat, abnormal amniotic fluid, heart disease and cardiac insufficiency, persistent weak contractions and no significant change even after using oxytocin drip, etc., who can be considered for cesarean section. Therefore, labor analgesia is required to meet the conditions of anesthesia, and everything is aimed at ensuring the safety of you and your baby.
4.Does painless delivery affect the baby’s health?
The local anesthesia technique used for labor analgesia is only a few milligrams and micrograms of drugs injected into the spinal canal, which anesthetizes the area below the mother’s navel, not directly through the mother’s vein, and the amount of drugs absorbed into the mother’s circulation and then absorbed through the placenta is minimal and has no adverse effect on the fetus. Clinical studies have now found that labor analgesia is safe and effective, and has beneficial effects on the mother and the baby. Studies focusing on placental-fetal endocrine function have shown that labor analgesia decreases maternal peripheral blood cortisol hormone, thereby reducing maternal stress during labor, and that cortisol concentrations in maternal cord blood and amniotic fluid do not change after analgesia. It was also demonstrated that the secretion of estrogen/progesterone and plasma prostaglandin E2 (PGE2) was not affected by labor analgesia. Other studies have also shown that the level of nitric oxide increases after labor analgesia, which contributes to the relative stability of maternal hemodynamics.
5.Can I choose my own anesthesia for cesarean delivery?
Cesarean delivery is an unnatural method of delivery and can only be chosen if the indications are met: breech position, fetal distress, placenta praevia, etc. The decision must be made by the obstetrician, after all, cesarean delivery increases many risks for the mother, so it is not possible for mothers to have a cesarean whenever they want. Cesarean delivery is the most important and common surgical intervention in obstetrics, as an effective means to solve difficult labor and some high-risk pregnancies, its rational application has saved the lives of numerous mothers and children. However, the abuse of cesarean delivery can also lead to increased maternal complications and mortality. The World Heahh Organization (WHO) has reported that the serious complications and mortality rates of pregnant women in the vaginal assisted delivery and cesarean delivery groups are significantly higher than those in the natural vaginal delivery group.
6.What is the most common type of anesthesia currently used?
At present, the most mature anesthesia technique for labor and delivery at home and abroad is intrathecal analgesia, in which the anesthesiologist places a drug injection tube in the lumbar area of the mother, and the concentration of the anesthesia drug in the tube is only about 1/10 of that in a cesarean delivery, so it is very safe. The pain will start to decrease after 5-10 minutes of anesthesia. Our hospital is operated by experienced anesthesiologists, which has a high safety factor and is widely recognized by mothers, and is also the standard way of painless delivery at present.
7.What preparations do expectant mothers need to make before delivery?
If mothers-to-be want to be brave enough to give birth by themselves, they must consider having labor analgesia, labor pain is unbearable, this you can get from the media and friends, if you want to have labor analgesia, please be prepared: avoid back skin infection, regular and proper exercise, giving birth by yourself needs strength, I have my own website on it, more online communication and exchange with us, improve the knowledge of labor analgesia, we will help you. We will provide you with help.
8. Can I still give birth with force after a painless delivery?
The first stage of labor, which requires the most rest and takes the longest time, can be rested sufficiently, so that when the opening of the uterus is fully opened and the mother wants to push, she will have more strength because she has accumulated energy. Some women can follow the doctor’s instruction to push downward if they don’t feel like pushing.
9.Does a painless delivery prolong the labor time?
No. In the past, the concentration of local anesthetic drugs used in painless delivery was high, and it did prolong the labor process.
10.Is it true that if I have a painless delivery, I can have a natural birth instead of a cesarean section?
No. Painless delivery can relieve pain during labor and reduce the rate of cesarean section, but it is impossible to avoid it completely. In case of fetal distress, cloudy amniotic fluid, abnormal prenatal bleeding and other abnormalities, an emergency cesarean section is necessary. However, it is no longer necessary to perform a back puncture, but only to inject directly through the epidural catheter the anesthetic drugs and doses required for the operation, which shortens the anesthesia time and facilitates the resuscitation of mother and baby. Postoperative analgesia is also available at the end of surgery.