Childbirth is a natural process by which we reproduce, but the pain caused by uterine contractions and nervousness and fear during labor is extremely painful for most pregnant mothers, especially those with their first child. On the Medical Pain Index, labor pain is second only to burning pain, so it’s pretty much the most painful thing most women experience in their lives! Why is labor pain so painful? What are the ways to relieve labor pains and at the same time make the delivery process smoother? Don’t worry, the following author to lead you step by step to unveil the veil of labor pains, explaining the magic formula to cope with. How painful is labor pain? This has considerable individual differences, everyone feels different. During the latent stage of labor, 80% of pregnant mothers are in moderate pain, and 50% of pregnant mothers feel severe pain during the active stage. Generally speaking, the pain during labor for mothers who are pregnant for the first time is more intense than that of mothers who have given birth to babies before. Since it is important to address or alleviate labor pain, it is important to first understand what causes labor pain. The primary cause of labor pain is the intense pain felt during labor when contractions cause pressure on the blood vessels of the uterus, tissue ischemia and hypoxia, and stimulation is sent up to the brain. In addition, the baby presses against the birth canal during contractions, which can also cause pain. There is also the psychological state of tension, anxiety and panic during labor, which increases the concentration of some pain-related substances in the body and intensifies the pain response. Some pregnant mothers say, “It’s okay, I can bear it, I can carry it, but I’m afraid that labor pains will have any adverse effects on labor and delivery.” In fact, labor pain can really have an effect on labor. First, it will increase oxygen consumption and energy expenditure, and metabolic acidosis may easily occur. Secondly, labor pains may slow down the progress of labor, or even lead to stagnation of labor, or even increase the rate of postpartum hemorrhage, increase fetal hypoxia and neonatal asphyxia. This is really “not say do not know, once said a shock”, since labor pains are so harmful, to cope with the treasure must know! Without further ado, I would like to introduce labor analgesia! Labor analgesia is in the protection of pregnant mothers and fetal baby safety principle, with drugs or mental therapy to reduce the pain of pregnant mothers in the process of labor. Divided into two categories: First, non-pharmacological analgesia: including breathing (Lamaz method is one of them), massage, water therapy, self-hypnosis, electric stimulation massage method. Second, drug analgesia: there are three kinds: intramuscular analgesia, intrathecal analgesia, laughing gas inhalation analgesia. At present, domestic and foreign experts and scholars confirm that intrathecal analgesia is the most accurate method of analgesia, which can achieve 70% to 95% of the pain relief effect! Therefore, the following space will be reserved for the “star of analgesia” – intrathecal analgesia! The four major advantages of intrathecal analgesia: 1, can improve the pregnant mother’s self-control and self-confidence, maternal safety; 2, to reduce the instrumentation to assist delivery, reduce the risk of newborn baby suction; 3, to eliminate the adverse effects of labor pain reflexes on the body, on the course of labor and the mother and baby have no significant impact; 4, pregnant mothers throughout the process of sobriety, can participate in the birth; However, intrathecal analgesia is, after all, a small surgical operation, has its own indications and contraindications. Indications and contraindications. Indications: If the mother is willing to have a vaginal trial of labor and is evaluated by an obstetrician (including keloid uterus, gestational hypertension, and preeclampsia). Contraindications: such as refusal by the pregnant mother, infection at the puncture site, abnormal coagulation, increased intracranial pressure, etc.; obstetric abnormalities, such as prolapsed umbilical cord, persistent weak contractions or abnormal contractions, placenta praevia, cephalopelvic disproportion, and pelvic anomalies. Having said that, many pregnant mothers may already be anxious to know when they can start using intrathecal analgesia, after all, pain is not wonderful at all. Starting to use intrathecal analgesia is something that must be a combination of theory and practice. The most recent U.S. Obstetric Anesthesia Guidelines state that labor analgesia should be given as soon as regular contractions begin and the mother requests analgesia. Therefore, the size of the mother’s dilated uterine opening is not the time to determine the start of intrathecal analgesia. However, in many hospitals, anesthesiologists and midwives are very short of manpower, and it is not easy to start intrathecal analgesia as soon as the mother enters the delivery room. In the hospital where I work, for example, pregnant mothers generally have the opportunity to have intrathecal analgesia when the uterine opening is dilated by 1-3cm. Therefore, if you plan to have intrathecal analgesia during labor, you should start to pay more attention to the choice of hospital. Pregnant mothers who can be assisted by intrathecal analgesia during labor also have some things to prepare for, as follows: Pregnant mothers should avoid eating a lot of solid, indigestible food, and can drink high-energy, non-dregulated beverages, so as to avoid the occurrence of food reflux aspiration during the emergency implementation of general anesthesia surgery. Sign the consent form for labor analgesia before performing intrathecal analgesia, and then cooperate with the anesthesiologist to set up the special position required for anesthesia puncture, and a special point to be mentioned is to urinate once every 2-4 hours after analgesia (if it is difficult to urinate, a nurse will need to catheterize the urine). Any one thing, no matter how many advantages it has, for people who do not understand, there will always be a number of questions, the author here summarizes some common questions about intrathecal analgesia: First, intrathecal analgesia will damage the spine? Intrathecal analgesia is performed by trained anesthesiologists and is located in the lower lumbar spine, which is safer. Will intrathecal analgesia harm the baby? Intrathecal analgesia is administered with the highest principle of maintaining the safety of the mother and the baby. The concentration of drugs used in intrathecal analgesia is only about one-fifth of that used in cesarean section, and the amount of drugs absorbed through the placenta is minimal, so there is no adverse effect on the fetus. Will intrathecal analgesia prolong the labor process? After the implementation of intrathecal analgesia, pregnant mothers can go through the vaginal trial of labor in a painless state, which relaxes the tension of pelvic floor muscles and facilitates the progress of labor and shortens the duration of labor. According to statistics, it takes about 10 hours from the opening of the uterus by 3 centimeters to the completion of labor for first-time mothers without intrathecal analgesia, while most of the mothers who use intrathecal analgesia can complete their labor in about 4-6 hours. Is intrathecal analgesia really painless? Technically, it can be painless. However, completely painless is not an optimal method as it may affect the uterine contractions leading to prolonged labor. Therefore a slight sensation of uterine contractions will be retained. And after entering the second stage of labor, pregnant mothers need to rely on this feeling to push. Fifth, after using intrathecal analgesia is it always possible to have a smooth labor? There are four elements for a smooth labor, which are labor force, birth canal, baby and psychosocial factors. We know that there are some unpredictable factors during labor: intrauterine oxygen deprivation, poor rotation of the fetal head, inability to connect well with the pelvic diameter, the fetal head does not descend, poor contractions, etc. If there is no progress after treatment by the doctor, cesarean section will be needed. Intravertebral analgesia itself does not increase the chance of cesarean delivery. Does intrathecal analgesia affect breastfeeding after delivery? Intrathecal analgesia has no effect on breastfeeding because the dose of the drug is small and passes through the placenta, and the drug will be metabolized quickly. Will intrathecal analgesia be painful after delivery? The puncture device of intrathecal analgesia can be used as a pathway for postpartum analgesia, which can relieve the pain of incision for women with perineal lateral incision, and also have analgesic effect on postpartum uterine contraction pain. Is the cost of intrathecal analgesia high? The drugs used in intrathecal analgesia are classical anesthesia drugs. Generally speaking, the hospitalization cost for a smooth natural delivery is the lowest, and the cost of applying epidural labor analgesia increases by about 1,000 yuan compared with that of natural delivery. IX. Will intrathecal analgesia lead to postpartum lumbar pain? After lumbar anesthesia puncture, there will be some dull pain locally at the puncture point, but it is usually mild and will disappear after a few days. Low back pain that lasts for weeks, months or even years after delivery is often not related to epidural anesthesia and labor analgesia! PS: The culprits of postpartum low back pain: laxity of the pelvic ligaments, imbalance of the physiological curvature of the spine, separation of the rectus abdominis muscle, physiological calcium deficiency, overwork, too long bed-ridden, pre-existing lumbar spine disease, post-partum depression and other psycho-psychological factors. It is true that some pregnant mothers are especially favored by God, labor pain is minimal, or even just back pain and swelling of the baby to give birth, but this is, after all, few and far between. Most mothers still have to struggle with labor pains during labor, so labor pain relief is a gift from God! Also, there are cases where labor is too fast for labor pains or the anesthesiologist is too busy, so Lamaz breathing and yoga breathing can be learned and practiced by pregnant mothers during pregnancy, just in case!