The practice of epidural anesthesia in our country has been around for several decades, but to this day there are a lot of myths floating around it, and women periodically hear horror stories about the damage this manipulation has caused to the mother and fetus. We are looking into the issue together with obstetrician-gynecologist Anastasia Markova.
Question. Friends and relatives dissuade me from using an epidural during childbirth, saying that it is harmful for both me and the baby. This is true?
Answer. The times when pain relief during childbirth was done with ether and opiates, which, of course, harmed the child, are a thing of the past. Epidural anesthesia is a modern method of pain relief that does not harm the child in any way, since anesthetics do not enter his body.
The meaning of epidural anesthesia is that in the first stage of labor, that is, during contractions, a cocktail of anesthetics is injected into the epidural space, which blocks the transmission of pain impulses through the nerve endings of the spinal cord, due to which an analgesic, that is, pain-relieving, effect is achieved. It begins to decrease towards the second stage of labor – pushing – so that the woman can feel her body and push correctly.
At the same time, there are still risks for the mother’s health during this manipulation, but only in cases where the dose of the drug is calculated incorrectly, and the anesthesia itself is carried out at the wrong time, for example, at the stage of full dilatation of the cervix. In this case, an epidural – as it is usually called by women in labor and by doctors themselves – can disrupt the course of labor.
If the dose of the drug is calculated incorrectly, before pushing the woman will still not feel her body, which means she will not understand how to push correctly and will not be able to distribute her forces and direct them to where they are needed. In this case, epidural anesthesia can indeed indirectly lead to ruptures and other complications during childbirth. But a qualified anesthesiologist will do everything to prevent this from happening.
Among the categorical contraindications to epidural anesthesia are the following conditions:
low blood clotting (few platelets in the blood); allergy to local anesthetics; bacterial or viral skin infection in the area where the catheter was inserted; severe diseases and heart defects (in this case, consultation with a cardiologist is required); severe liver diseases that cause decreased blood clotting; severe pathologies of the nervous system; presence of tattoos at the puncture site. Tattooed skin is considered susceptible to infection. This point is discussed individually in consultation with an anesthesiologist.
A good anesthesiologist, having collected a complete history, always chooses the right type of anesthesia. For example, someone may not be suitable for epidural anesthesia due to problems with the spine, then a combined spinal-epidural or spinal anesthesia is performed.
You can often hear that after epidural anesthesia your legs feel weak and you feel dizzy. However, problems with legs largely depend initially on the condition of the musculoskeletal system and, in particular, on the condition of the spine. If a woman has scoliosis, then the epidural space is also not located quite as usual, and then anesthesia can lead to short-term unpleasant effects.
As for headaches, they are associated with a sharp decrease in blood pressure and can be provoked not only by epidural anesthesia, but also by any other manipulation that affects blood pressure.
In any case, the decision about whether to have epidural anesthesia or not can only be made by a woman, basing her decision on her own experience, attitude and doctor’s recommendations. Nothing prevents a woman from going into labor without an epidural, and then depending on the situation.
Of course, there are many techniques during childbirth that allow you to do without the use of painkillers. These are, for example, massage, warm bath, aromatherapy. But all these procedures to help a woman in labor should be carried out by a professional midwife or doula.
In addition, each woman has her own pain threshold. And what some perceive as mild discomfort and compare with pain during menstruation, for others it is unbearable pain. Some women are preparing for childbirth, learning breathing techniques and preparing for natural childbirth without anesthesia, while others are afraid and want to play it safe in advance.
There is no single right solution here. But in the competent hands of an anesthesiologist, epidural anesthesia certainly makes labor easier. Now, for example, the trend is epidural anesthesia, in which a woman can get out of bed and actively move, the so-called mobility during childbirth.
The obstetrician-gynecologist leading the birth always carefully monitors the dynamics of labor and offers epidural anesthesia when it is really needed. But it is important to remember that there is a point of no return, a time after which it is undesirable to do it, in order to begin pushing, feeling your body, since during this period you will really have to work hard.
Be that as it may, every woman has the right to a painless birth. And if earlier it was a privilege, now anesthesia is available to everyone.
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Photo: Iryna Inshyna / Shutterstock / Fotodom
2023-09-08 21:00:16
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