In fact, giving birth doesn’t have to be that painful. Expectant mothers need to learn about labor analgesia!

Author: Xu Mingjun, Chief Physician, Beijing Obstetrics and Gynecology Hospital, Capital Medical University

Deputy Director of the Obstetric Anesthesiology Group of the Anesthesiology Branch of the Chinese Medical Association

Reviewer: Duan Hua, Chief Physician, Beijing Obstetrics and Gynecology Hospital, Capital Medical University

Giving birth is like walking through the gates of hell for women. The pain of uterine contractions is excruciating and excruciating. Pain is generally divided into 10 levels, and the pain of natural childbirth is about 9 levels. You can imagine how painful it is. Mothers who have given birth naturally have a deep understanding of this.

With the advancement of medicine, "labor analgesia" technology has been widely used and favored by pregnant mothers, so that pregnant mothers who are about to give birth no longer fear the pain of labor.

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Labor analgesia, also known as painless childbirth, is a way to minimize pain during childbirth through anesthesia. Labor analgesia can be used for most pregnant mothers, unless it is not allowed in some individual cases.

Labor analgesia is to inject anesthesia into the back. If there happens to be infection or ulceration in the back, it cannot be injected to avoid infection. Safety is the first priority. Or if there is spinal deformity, spina bifida, or surgery has been done on the anesthesia site, or there is a coagulation disorder, or a sudden fever during delivery, these situations are not suitable for painless injection. However, in these situations, natural childbirth is generally not chosen, and cesarean section is generally used.

Generally speaking, pregnant mothers who can give birth vaginally can generally accept painless delivery. Of course, before painless delivery, in order to ensure safety, obstetricians and anesthesiologists will conduct a detailed assessment to see if painless delivery is suitable.

Many pregnant mothers who have not experienced painless childbirth are curious: Is it really painless to give birth after painless childbirth? Will it have any effect on the baby?

1. Is painless childbirth really painless?

In our country, pregnant women are generally allowed to retain some mild uterine contraction pain, so that they can experience the uterine contractions, rotation and descent of the fetal head during delivery.

If the pain is divided into 0-10 points, it will reach about 9 points before the analgesic is given, and basically controlled at 0-3 points after the analgesic is given, so that it will not affect the mood and rest of the pregnant woman too much. Of course, it can also be controlled at 0 points, but 0 points is not pursued.

2. When can I get an epidural after delivery?

It is currently believed that as long as there are symptoms of threatened labor, from the beginning of regular uterine contractions to the delivery of the fetus, pregnant women can be given labor analgesia at any time, but analgesia measures are generally taken in the first stage of labor.

There are four stages of labor:

The first stage of labor is from regular uterine contractions to full cervical dilation, which takes about 9-13 hours.

The second stage of labor is from full dilation of the cervix to delivery of the fetus, which takes about 2 hours.

The third stage of labor is from the delivery of the fetus to the delivery of the placenta, which takes about 15-30 minutes;

The fourth stage of labor is from delivery of the placenta to 2 hours after delivery.

3. How is anesthesia administered for painless childbirth? How long does it take for it to take effect?

Epidural labor analgesia starts with lumbar puncture. During the puncture, you need to remain in the side-lying position. Then a thin catheter is placed into the anatomical position of the epidural space. Analgesic solution is infused continuously, at a constant rate, and in small doses through the catheter to produce a certain amount of nerve block, so that you don't feel pain.

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After the puncture, you can adopt a free position. Any position is fine. Don't force it. Do whatever is comfortable for you. The free position is believed to promote the progress of labor. You just need to pay attention to the tube placed behind your back and make sure not to drop it.

So, how long does it take for the medication to take effect? ​​From medication to no longer feeling pain, it takes about 15-20 minutes, and generally about 18 minutes.

4. Does painless childbirth have any impact on pregnant mothers and fetuses?

Based on the analysis of a large number of clinical cases in my country, epidural labor analgesia currently has no effect on either the pregnant mother or the fetus.

For pregnant mothers, epidural labor analgesia can not only reduce pain, but also relieve psychological anxiety and fear. Moreover, compared with cesarean section, the amount of anesthetic used in epidural labor analgesia is only 1/10-1/5 of that in cesarean section.

For the fetus, when the pregnant mother gives the painkiller, the blood supply of the placenta will be richer, which can provide more blood and oxygen to the fetus and relieve the fetal distress in the uterus.

5. Do I still have the strength to give birth after painless childbirth?

In fact, giving painkillers does not affect childbirth. Pregnant women can also walk and stroll after taking the drugs, so they have the strength to give birth.

If there is an impact, it may affect the giving of some signals. For example, when the cervix is ​​fully dilated, the fetal head presses on the rectum, and the pregnant woman will have a strong urge to defecate. The urge to defecate may be weakened after taking analgesics. This may have a slight impact on the pregnant woman's push, but it does not affect the second stage of labor. Just hold your breath and push under the guidance of the midwife.

Some pregnant mothers may worry about whether taking analgesics will weaken uterine contractions. In fact, uterine contractions may be strengthened after taking analgesics. This is because strong pain stimulation may promote the release of adrenaline, excite the sympathetic nerves, and inhibit uterine contractions. After taking analgesics, less adrenaline is released, the sympathetic nerves are not excited, and the factors that inhibit uterine contractions are reduced, which may strengthen uterine contractions.

Maternal love is great and selfless. I hope that every pregnant mother can reduce labor pain and have a safe delivery with the help of labor analgesia.