Frequently Asked Questions about Painless Childbirth For more than a century and a half, people have been searching for ways to give birth in a conscious, pain-free state. There are many factors that influence the level of pain experienced during labor: the mother’s psychological preparation, emotional support during labor, the mother’s experience with labor, abnormal fetal position, and the use of contractions. Labor and severe pain go hand in hand and are often unexpected, 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, backache, and pain from deep lacerations. A survey reported that 60% of first-time mothers in the first stage of labor described contractions as “unbearable, intolerable, and extremely painful”. As early as in the 18th century, Queen Victoria of the United Kingdom successfully used laughing gas to carry out painless labor, painless labor in Western countries has been quite popular, the United States maternal choice of painless labor accounted for 85% of the United Kingdom as high as 90%, while China’s implementation of painless labor less than 1%. With the improvement of living standards and the implementation of China’s family planning policy, most women only have one child, they do not want to suffer from the pain of labor, they can not withstand the blow of cesarean section in the middle of the labor process, they can not accept the possibility of the fetus in the long process of labor and delivery of hypoxia and injury, and resolutely choose to give birth to a cesarean section. In fact, at present, we have no technical problems in allowing women to enjoy painless labor, but what is needed is to vigorously promote it. The development of labor analgesia solves the problem of pain, increases the courage and confidence of mothers, and improves the rate of vaginal delivery. The correct implementation of analgesia during labor helps to improve the quality of perinatal period and the physical and mental health of mothers. At present, some introductions about painless delivery in the media and on the Internet are one-sided and lack of science. The Department of Anesthesiology of Obstetrics and Gynecology Hospital Affiliated to Fudan University has been carrying out painless delivery for a long time, and some common knowledge and problems of painless delivery are introduced as follows. 1.Is painless labor really painless? Pain is the subjective feeling of individuals, which varies from person to person. The drugs used in our hospital for labor analgesia are ropivacaine and sufentanil, ropivacaine has a good “separation of anesthesia”, that is, it only blocks your pain sensation without affecting the muscle strength, and you can have normal movement; sufentanil is the strongest analgesic drug with the smallest side effect at present, and current technology can reduce or minimize the pain. The current technology allows for a less painful or completely painless labor and delivery, depending on the mother’s request and response. We suggest that retaining the sensation of mild uterine contractions is the best way to have a painless labor and delivery. According to statistics, 85% of mothers have no pain at all after painless labor, and 12% of mothers have a suitable degree of relief. 2.Can all mothers who want to have a normal labor choose to have labor pain relief? Not all mothers who want to have a normal delivery are suitable for labor analgesia, for example, some mothers have skin infection on the back, or suffer from sepsis, coagulation disorders, and also have back injuries, spinal surgery, etc., which are not suitable for choosing labor analgesia. Other mothers: abnormal birth canal, fetal position, placenta praevia, poor fetal heart, amniotic fluid abnormalities and other obstetric anomalies, suffering from heart disease and cardiac insufficiency, persistent contraction weakness, the use of oxytocin drip is still no significant change, etc., can be considered to carry out a cesarean section. So labor analgesia is needed to meet the anesthesia conditions can be, all to ensure the safety of you and your baby for the purpose. 3.Will painless labor affect the baby’s health? Labor analgesia using local anesthesia technology, only a few milligrams and micrograms of drugs injected into the spinal canal, anesthesia is the mother’s navel below the part, not directly through the mother’s vein into it, the amount of drugs absorbed into the mother’s circulation, and then through the placenta to absorb the drug is minimal, the fetus also has no adverse effects. Clinical studies have found that labor analgesia is safe and effective, and has beneficial effects on both mother and baby. Studies focusing on placental-fetal endocrine function have shown that labor analgesia reduces maternal peripheral blood cortisol hormones, which in turn reduces the stress of labor, and that there is no change in cortisol concentrations in umbilical cord blood or amniotic fluid after analgesia. It has also been shown that the secretion of estrogen/progesterone and plasma prostaglandin E2 (PGE2) is not affected by labor analgesia. There are also other studies that show that the level of nitric oxide can be increased after labor analgesia, which is conducive to the relative stability of maternal hemodynamics. 4.What are the reasons for the lack of popularity of labor analgesia in China? The reason for such a low rate of labor analgesia in China is that non-technical factors play a dominant role: ① The degree of knowledge of pregnant women and their families about labor analgesia and the level of relevant education. Most pregnant women are not aware of advanced labor analgesia methods. From July to September 2006, we conducted a questionnaire survey on pregnant women in different levels of hospitals in Guangzhou, 1000 questionnaires were distributed, and 982 valid questionnaires were returned. Among the 982 pregnant women who knew about labor analgesia, 5.4% of them were very clear about labor analgesia, 22.1% of them had some knowledge about it, 41.3% of them had heard of it but were not clear about it, and 31.2% of them had never heard of it. Mothers who are very clear about labor analgesia most want to use labor analgesia for delivery, the rest of the pregnant women most want to give birth naturally without any analgesia or surgery, and most of the pregnant women said that they can be open to labor pains or have no fear of it, but some pregnant women who have never heard of labor analgesia or have only heard of it have a great deal of fear of labor analgesia. ② Obstetricians and midwives’ recognition and acceptance of labor analgesia. The concept of medical personnel is relatively backward, especially obstetricians and midwives, the epidural analgesia is still stuck in the past concept that analgesia will inevitably affect the contractions, labor, labor force and so on. In addition, after analgesia and the usual labor scene is very different, the midwife Kunming painless abortion need to be more careful to observe the labor process and the opening of the mouth of the uterus, can not be judged according to past experience, to adapt to the “quiet” in the delivery as soon as possible. A questionnaire survey on analgesia in childbirth was conducted among the medical staff of the anesthesiology department, labor and delivery ward, obstetrics department, and other departments of the Beijing Maternity Hospital. A total of 530 questionnaires were distributed and 504 (95.1%) were returned. Among all medical staff, 93.3% had heard of intrathecal labor analgesia, of which 14.4% had a clear understanding of it, 48.8% believed that intrathecal labor analgesia was only suitable for women in whom other analgesic measures were ineffective, 32.2% believed that non-pharmacological methods were the best labor analgesic methods at present, 42.4% were in favor of intrathecal labor analgesia, and 57.4% held the attitude of neither favoring nor opposing it. Attitude. (iii) Anesthesiology department’s enthusiasm to actively develop new business and awareness of participation. Many hospitals have a shortage of anesthesiologists, who are too tired to deal with daily surgeries and have no time to work on labor analgesia. In the questionnaire survey mentioned above, the biggest obstacle to the development of labor analgesia was the lack of sufficient anesthesiologists (55.3%), which accounted for the first place. According to the current pricing of public hospitals, cesarean section is much more profitable than natural delivery. The application of painless delivery of natural delivery only increases the charges by about a few hundred dollars, the universalization of painless delivery, hospitals in the workload has increased exponentially, the medical risk of the situation, the hospital revenue will instead be reduced. This largely restricts the popularization of painless childbirth in China. 5.Cesarean section anesthesia can be chosen by myself? Cesarean section is an unnatural way of delivery, only meet the indications: breech position, fetal distress, placenta previa, etc. can choose, and must be decided by the obstetrician, after all, cesarean section of the mother increases the risk of many, so can not mother want to cesarean section can be. Cesarean section is the most important and common surgical intervention in obstetrics. As an effective means of solving the problem of obstructed labor and delivery in some high-risk pregnancies, its rational use has saved countless mothers’ and children’s lives. However, the misuse of cesarean section can also cause maternal complications and increased mortality. The World Health Organization (World Heahh Organization, who) on the global cesarean section survey report pointed out that the vaginal assisted delivery group and cesarean section group of pregnant women with serious complications and mortality rate is significantly higher than that of the vaginal natural delivery group, so mothers should pay attention to prenatal preaching, awareness of cesarean section of the pros and cons. 6.What is the most commonly used anesthesia? At present, the most mature anesthesia delivery analgesia technology at home and abroad is intrathecal analgesia, in which the anesthesiologist places a drug injection tube in the waist of the delivering mother, and the concentration of anesthetics in the tube is only 1/5 of that of cesarean section, so the safety is very high. Generally, after about 10 minutes of anesthesia, the pain will start to decrease. Our hospital is operated by experienced anesthesiologists with high safety coefficient, which is widely recognized by mothers and is also the standard way of painless childbirth at present. 7.What kind of preparation does the mother need to do before the operation? Mothers-to-be, if they want to be brave enough to give birth on their own, must consider labor pain relief, labor pain is unbearable, this you can get from the media and friends can be confirmed, if you want to do labor pain relief, please be well prepared: to avoid back skin infections, often appropriate exercise, their own birth is the need to have the strength, I have their own website, more on the Internet and our communication and exchange, to improve the understanding of labor pain relief, we will provide you with help. We will provide you with help. 8.It is said that whether the anesthesia is in place or not is very critical during cesarean delivery, how to explain this? By “whether the anesthesia is in place or not”, does it mean whether the plane of anesthesia is appropriate? The plane is too high, the mother will appear low blood pressure, nausea, vomiting, the baby will be certain lack of oxygen; anesthesia plane is too low, the pain has not been completely blocked, will feel the pain, muscle contraction, out of the head of the fetus is difficult, and often poses a threat to the life of the baby, so the best abortion hospitals in Kunming anesthesiologists in place or not, determines the cesarean section process of the safety of mothers and their babies, only the appropriate plane to allow mothers to have no Only the right plane can allow the mother to have no discomfort and comfortably let the baby come to this world. 9.Many moms feel that their memory deteriorates after cesarean delivery, is there any medical basis for this? There is no scientific basis for this, any visual and auditory information that stimulates our sensory organs can constitute a very short memory, less than 1 second. If it is not transferred to short-term memory storage, it will fade quickly, which is sensory memory. Often hear people introduce their last name, if you do not put in mind, immediately forget. If a piece of information is put into your attention, after some thinking and connection, it becomes short-term memory, which can be maintained for a few seconds to a few minutes. This process is related to the temporal lobe of the brain, which is just the initial processing of the brain. If this information is further processed, encoded in some way, or used repeatedly, the information is stored in multiple parts of the brain and becomes a long-term memory, which can last for hours, days, months, or even a lifetime. The mother has experienced a great change in life experience after the October pregnancy, especially physiological and psychological changes, during pregnancy and a long period of time after delivery relatively detached from the previous social relations, relatively closed, the mother in the postpartum period often show anxiety, anxiety, etc., unable to concentrate on the psychological changes. Whether or not one’s attention is focused when touching a certain thing, and whether or not one’s emotions are normal enough, are very relevant to the length of time that memory is retained. If one is suspicious, anxious, inattentive and unable to build a solid memory, it means that the memory is related to high attention and emotions rather than brain damage leading to memory loss, which can be gradually improved with appropriate treatment and correction.