I noticed that most visitors to the site believe that since childbirth is a natural process, no anesthesia is required. However, there are many who are afraid of pain. In addition, pain relief is usually offered not at the request of the woman, but according to indications; it can also be offered to a woman who is ready to endure as much pain as nature allocates to her.
Non-drug methods of pain relief
Most women have probably heard that 70% of the intensity of pain is due to its perception and fear. Therefore, the logical conclusion is that if a woman is committed to a successful delivery and is not afraid of anything, then the pain will be less and the birth will be easier. However, unfortunately, we cannot always set ourselves up the way we want; we even seem to understand with our minds that there is no need to be afraid, but we are still afraid.
This is why preparation for childbirth is so important. Moreover, it is advisable that it should not be started a week before the birth, since a positive attitude may not be formed so quickly. Schools for pregnant women are very helpful, where they talk about the physiology of childbirth and the origin of pain (after all, the unknown increases fear). Recently, the head of one of the maternity hospitals, in an interview on the website, expressed the opinion that such schools more harm than good. I think what was meant is that some schools form a negative attitude towards any medical manipulations and to doctors in general. This also happens, so you need to “filter” the information - remember tips on how to help yourself during childbirth, but do not be categorical about medical care. It is better to choose a school where there are classes with both psychologists and obstetricians-gynecologists.
Communication with young mothers is also useful; it helps to understand that low-pain childbirth is not so rare.
In addition to the psychological attitude, there are also some
Techniques to slightly reduce the intensity of pain:
Firstly, this is correct breathing. It is recommended to breathe during labor as follows: during contractions, take a deep, slow breath in through your nose, then exhale slowly through your mouth. Do not hold your breath. Breathe calmly between contractions. In this case, it is worth concentrating on breathing, this helps to distract from the pain and makes the birth process easier for the baby. At the end of the first stage of labor, when the desire to push arises, you need to either breathe frequently “like a dog,” or, on the contrary, use deep slow breathing (deep inhalation and exhalation through the mouth), as you prefer. During pushing you need to dial full breasts air (as if you are going to dive under water), and with this air it is as if you are pushing the pain out of yourself; when the air runs out, quickly exhale and immediately inhale again, without “breathing” through the effort (you can catch your breath between attempts, the effort should be used to the maximum) .
The next pain-relieving technique is pressing on the bony protrusions. Needed with inside press on the bones protruding on the sides of the lower abdomen. Some people find that kneading their lower back helps. The husband helps a lot with this if he is present at the birth. You need to knead and rub your back intensively, until you feel slight pain, this distracts you from the pain of labor.
To relax between contractions, you need to imagine some situation where you feel good and pleasant, you are resting. For example, imagine lying on the seashore and listening to the sound of the waves. Or how you hold a small, warm baby close to you. It’s better to think in advance what you will imagine, practice painting a picture and your feelings in colors (because already in childbirth, when you experience pain, as luck would have it, it’s difficult to remember something pleasant).
Also during childbirth you can use the well-known NLP technique anchoring. A few days before giving birth, when you feel especially good and pleasant, you experience strong positive emotions, massage your wrist. By doing this you will create an “anchor” in the wrist area for a positive emotion, and then during childbirth, when you massage your “anchor”, you will feel the emotions and sensations with which this “anchor” is associated. (The anchor can be any area. The wrist is an example.)
In preparation for childbirth, you need to learn to relax your muscles so that they obey you, since muscle tension increases pain. This is taught at gymnastics for pregnant women. The technique is that you try, for example, to strain right leg And left hand, A left leg And right hand relaxed as much as possible, then change tension and relaxation. In general, you need to tense individual parts of the body. The rest should be relaxed. This way you will learn to control your muscles so that they relax as you wish. This is easy enough in normal life, but difficult when you are in pain and everything is shrinking.
Drug pain relief
Such a simple and familiar drug as no-spa can reduce the pain of contractions.
No-spa can be administered both intravenously and intramuscularly. No-shpa does not cause oppression labor activity and does not have a negative effect on the fetus. First of all, no-spa relaxes not the body of the uterus, but the cervix, due to which the opening of the cervix occurs faster. Therefore, no-spa can be used simultaneously with stimulation of labor.
No-spa is also used for differential diagnosis between the onset of labor and “false” (preparatory) contractions. If the contractions are “false”, then after the introduction of no-shpa they will stop within half an hour. If labor has begun, the contractions will continue.
Sometimes narcotic analgesics are used to relieve labor pain. The most famous is promedol. It is administered intravenously or intramuscularly, the effect lasts 2-4 hours, the opening of the cervix when administering promedol should be at least 3-4 cm. It does not completely relieve pain, but significantly reduces its severity. In addition, promedol has a calming effect, which changes a woman’s perception of pain. Typically, promedol is used when a woman in labor is tired. After the administration of promedol, the woman most often falls asleep (medicated sleep-rest). This is a prevention of secondary weakness of labor. After such medicated sleep, regular contractions of good strength are usually restored and positive dynamics are observed in the opening of the cervix.
However, this drug also has side effects. The most serious of these is fetal respiratory depression. After birth, the baby is lethargic, drowsy, and does not immediately latch on to the breast. The inhibitory effect of promedol on the fetus is most pronounced if the drug is administered 2-3 hours before birth. In addition, when promedol is administered, a woman may experience nausea and vomiting. If the negative effect of promedol is pronounced, the woman and/or child is given a promedol antagonist, naloxone.
The drug is completely eliminated from the mother's body within 2-3 days, so in the first days the child may receive an additional dose of promedol with mother's milk, which is why he may be somewhat lethargic and drowsy. This does not pose a danger to the child’s health, since the dose he receives is very small.
Epidural anesthesia
The next method of pain relief is epidural anesthesia. In this case, an anesthetic substance is injected into the space above the hard shell spinal cord. The most widely used drugs for this purpose are lidocaine and marcaine. The woman sits with her back to the doctor, bending over and tilting her head forward (or lies on her side, bending her back as much as possible - curled up). The doctor numbs the site of the intended puncture with an injection of novocaine. After this, the epidural needle is inserted between the vertebrae into the epidural space. A catheter (a thin plastic tube) is then inserted through the needle and the needle is removed. A syringe containing an anesthetic is attached to the catheter. Subsequently, the catheter is not removed until the end of labor, since, if necessary, an anesthetic substance can be added during labor. The effect begins 15-20 minutes after the administration of the anesthetic.
Indications for epidural anesthesia are severe gestosis (late toxicosis) during pregnancy, chronic diseases kidneys, heart, lungs, young age of the woman in labor, severe myopia (myopia), arterial hypertension(increase blood pressure). Also, epidural anesthesia is performed in cases of incoordination of labor (when, during strong painful contractions, the cervix dilates weakly, the rate of dilatation does not correspond to the strength and duration of contractions).
Contraindications for epidural anesthesia: spinal injuries or surgical interventions on the spine, bleeding disorders or taking medications that affect blood clotting, a scar on the uterus after a cesarean section or other operations, low blood pressure, pustular formations on the skin near the site of the intended puncture. In some cases, performing this type of anesthesia is difficult due to the woman’s severe obesity, because the doctor cannot feel the bony landmarks.
With this method of pain relief, pain sensations are completely turned off, but all other types of sensitivity are preserved. The woman can move, feel touch, she is completely conscious. Only the first stage of labor (the period of contractions) is anesthetized. By the end of the first period and the beginning of the pushing period, the anesthesia should wear off, as the woman must feel increased pain when pushing to understand that she is pushing correctly. After childbirth, if necessary, pain relief can be resumed (for example, when suturing ruptures in the birth canal).
With epidural anesthesia, the duration of labor usually increases. This is due to the fact that the strength of contractions decreases somewhat. In addition, a woman may experience a decrease in blood pressure to the point of fainting. Negative effects on the fetus during this method no pain relief was noted. IN postpartum period some women report headaches and temporary numbness in their legs.
The use of epidural anesthesia for everyone causes controversy among both doctors and women in labor. Some people wonder why in Western countries pain relief is provided to everyone without exception, but in our country it is not. Probably because our women themselves do not strive for this. In addition, it is known that the frequency caesarean sections in Western countries is higher, and many attribute this specifically to the use of epidural anesthesia and the occurrence of weakness in labor. At the same time, in my opinion, it is not worth canceling anesthesia at will, because fear and excessive pain in themselves are factors that can lead to abnormalities in labor.
Some opponents of epidural anesthesia argue that the use of pain relief during childbirth disrupts the psychological bond between mother and child. This thesis raises some doubts for me, since not a single method completely eliminates pain during childbirth; during the most crucial period of pushing, the woman fully feels everything that is supposed to be, so even if we assume that it is necessary to experience pain, this condition is met. Psychologists do not say that you need to experience pain for no less than a certain time, otherwise some statements would appear, for example, about the disruption of the connection between mother and child during rapid childbirth.
The argument that ancestors gave birth without any medical assistance also does not stand up to criticism, because when they gave birth without assistance, there was natural selection and a fairly high mortality rate during childbirth.
In conclusion, I want to say that, of course, the fewer medical interventions, the better, but the restrictions must be reasonable, and if the benefits greatly exceed possible risk, then you should not abandon the achievements of civilization.
Girls, mommies! Who was injected with promedol as a pain reliever during childbirth?! What can you tell us about this?!
Comments
Beauty 😂😂😂 it’s a shame you can’t do it twice 😅😅😅😅
- @koroleva_ekaterina, my doctor, where I plan to give birth, says that she does not recommend an epidural, but this is best😂 it’s just a narcotic analgesic, that’s interesting
- @koroleva_ekaterina, how long does pain relief last??
- @kseniiaakhr, 4-5 hours is definitely enough, they do it when the whole opening is large, there is no connection with the Child, you are already two separate organisms. But you don’t yell like a fool, but you gain strength and you don’t injure the child with your nerves by arching... I am for any anesthesia! I don’t see the point in these sacrifices; no one will appreciate it, but you yourself will remember with horror all these pains😁
Two hours of sleep) cool thing)
Tell me, why is this? With me, a girl gave birth to her, they did it for her and she only moaned a little, but in response to my pleas to do something, they only increased the speed of contractions! Or they think that if you give birth 3 times, it’s easier to bear!!! (oh how wrong they are)
- @koroleva_ekaterina, I am also for anesthesia! It’s interesting to learn about the sensations, and in general to listen to someone else’s experience 😉 the doctor told me that they are dilating it at 3-4 cm! How does it feel?! Do you just not feel pain or do you feel like you’re drunk?!
- @natashka1986, I wonder why this is? I didn’t understand the question and to whom it was addressed 😂
Yes to everyone!!! It’s just not clear that some people do it and others don’t! It’s paid????? but they didn’t even offer me!
I was injected with it after a caesarean section, twice.
They did it for me, but the opening was already large! I slept between contractions!!! I used to think that these were just stories and that it was impossible))) the doctor himself decides whether it’s necessary or not!
- @natashka1986, maybe it also depends on where you give birth, because different maternity hospitals have their own methods of pain relief.. Where did you give birth? I think this anesthesia is paid..
- @iriska211, and how do you feel?! Does the pain just disappear or do you feel like you’re drunk?!
They did the same for me in the 20th department of the Pirogov hospital. 4 years ago free.@kseniiaakhr
- @olia170390, I’m also planning to go to Pirogov.. Didn’t you give birth to your second child there?
- @natashka1986, It's free. It’s just that in our medicine, in order to account for the spent ampoule of the drug, the doctor needs to fill out so much paper and accounting logs, and also store these broken ampoules and hand them over to the competent authorities. It is in hospitals that people like to look for violations of the storage and use of drugs. So doctors try not to use it unless absolutely necessary. But the drug is good, it helps open the cervix at the same time as it has an analgesic effect
They injected me. It had a terrible effect on me. It’s just that everything is in a fog and I feel pain. Just like I’m drunk. I’ve only never gotten so drunk in my life. I also felt nauseous.
- @kseniiaakhr, you don’t feel pain, there’s only labor, you feel like the contraction is like being stroked on the stomach, basically everyone is sleeping
They did it to me. I slept for about 2 hours. But then I faintly felt the contractions. When they did it, I felt a little dizzy and fell asleep.
- @koroleva_ekaterina, Promedol sucks! It didn’t have any effect on me at all, what’s the point of sleeping there! The contractions felt absolutely the same! It just makes me nauseous...
- @natashka1986, so I begged to do at least something and nothing! Haven’t they really come up with anything other than an epidural (I wrote about promedol above)
- @citramon, do you mean they keep their broken ones?!
By the way, the consciousness was absolutely clear after the break, only the tongue was slurred like that of a drunk)))
- @stelli, that means they didn’t inject you with it😆 It’s a narcotic drug that knocks out an elephant... It’s the same as many people say - the epilural did not work on me - laughter! Divorce is all medical, you can inject a noshpa and say anything you want.
- @kseniiaakhr, I didn’t express myself correctly, I meant used ones, because if you throw away the fragments of the ampoule, how will you later prove that you are not selling drugs 😃 but in healing process use it! So once again they prefer not to mess with him
- @koroleva_ekaterina, it all depends on the dose, they injected me a little for my neck, I didn’t feel the intoxicating effect at all
- @kseniiaakhr the pain goes away for a few hours)))
This is what they did to me at 21 for free, remembering the sensations of the first and second births. (The second was with a load of 116, it’s nothing at all). I just didn’t know the name, apparently not such a large dose of TC between contractions made me sleepy, but I felt the pain like crazy. but compared to a backpack it’s still lighter. so it’s a good thing)))
- @kseniiaakhr, the second one in Seredavina. After giving birth at 20, I decided not to risk it and have a c-section in a good maternity hospital. There are no comrades according to taste, but at 20 I did not like the attitude of the doctors or the conditions.
They injected me with promedol, it was terrible for me, like I was crazy drunk, but the pain was still terrible.
I just got it injected, at first I felt very dizzy and then for seconds without any pain I suddenly passed out, the pain was the same, but it was still easier
I couldn’t wake up from it, it made me feel terribly sleepy, but I also felt contractions, my head was spinning, I couldn’t get up, but I understood this individually, since I had girls with me who were cheerful)))
- @koroleva_ekaterina, It’s impossible that it’s not his - it’s just that everything seems individual. From but-shpy you don’t get drunk) we are talking about the analgesic effect - there was none. As for the epidural, I heard the same thing, that there are cases when it doesn’t work, but this is with the wrong dosage and usually you just inject the right amount of anesthetic and that’s it! For example, I have more than positive experience with this type of anesthesia))
- @stelli, this drug does not have an analgesic effect in small dosages, read the pharmacology calculation for the patient’s weight... If calculated correctly for dulling pain syndrome then this is the strongest thing that can be offered to a woman in labor...
- @koroleva_ekaterina, okay, I don’t want to argue, probably you come across such stupid doctors in different maternity hospitals, with a time difference of 9 years, that they can’t even calculate my dosage correctly)) both times ABOUT NOTHING!
- @stelli, I’m not arguing with you, I’m just talking about pharmacology, I didn’t come up with this)))))) there were girls who wrote that epilural did not work on them... Maybe they don’t have a spinal cord in their spine, where do I get it from? know... I only have theoretical knowledge of this... True, everything from familiar doctors works for me, but from random ones and ice caine is like water
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Popular medicinal pain relief for childbirth
Undoubtedly, childbirth is greatest event in a woman's life. But we will need a lot of strength, patience and diligence before meeting the baby. However, this is not what usually frightens pregnant women. The most common fear before childbirth is the fear of pain. Many women ask doctors for drug pain relief during labor. But are these procedures as “harmless” as some expectant mothers think?
Women's perception of pain during childbirth varies significantly. This process is completely controlled nervous system, and it is fear that reduces the threshold of pain sensitivity. It turns out to be a kind of vicious circle: we hurt because we are afraid of pain.
When is drug pain relief necessary?
Sometimes during labor there is a need for additional drug pain relief. For example, medication assistance necessary in the event of the development of certain anomalies of labor that increase the duration of labor. Such deviations include: weakness of labor, incoordination (dysregulation) of labor, premature rupture of amniotic fluid (occurring before the onset of contractions or simultaneously with them).
These conditions really lengthen and complicate labor and take away the strength of the woman in labor. But the strength to the expectant mother are very necessary: at the end of the second stage of labor she will have a big physical labor- push! In order for a woman to rest and gain strength for the decisive event, painkillers are used during childbirth.
In addition, some women in labor have a pathologically low pain sensitivity threshold. In other words, these women feel pain much earlier and much stronger than it should normally be. Of course, in this case, women also need additional drug pain relief during labor. It also happens that the use of drug pain relief is determined by the woman’s desire; this, as a rule, is possible when conducting childbirth under a voluntary health insurance contract.
Pain relievers
We will tell you about the most commonly used medicines pain relief is available to obstetricians and anesthesiologists. These include narcotic analgesics and regional anesthesia drugs such as: Promedol, Epidural anesthesia and Nitrous oxide.
Promedol
Most often, promedol is prescribed for pain relief during labor. This drug belongs to the group narcotic analgesics To put it simply, it is a drug. It can be administered intramuscularly (which is preferable) or intravenously.
It is assumed that under the influence of the medicine you will be able to get a break from 30 minutes to two hours: relax and even sleep. In reality, it is quite difficult to predict in advance how a woman will react to the introduction of promedol.
There are women who, after such anesthesia, sleep peacefully until the birth of the baby, while others only get the opportunity to take a nap in between contractions. Promedol penetrates the placental barrier, and the baby also sleeps during the period of action of the drug. This feature is associated with the upper time limit for pain relief with promedol - no later than two hours before the birth of the baby.
Therefore, after the cervix is dilated by 8 cm, promedol is not administered. After all, after being born, the child must take his first breath on his own, which means he should not be sleepy. It is also not customary to prescribe narcotic analgesics before the cervix is dilated by 4-5 cm, as this may contribute to the development of weak labor forces.
In addition to the actual pain relief of labor, promedol is also prescribed for the treatment of various pathologies of labor. For example, it is always used as an application (to mitigate the effect) before the introduction of a labor-stimulating substance - Oxytocin - when correcting weak labor.
TO possible complications when narcotic analgesics are administered during childbirth, nausea, vomiting, drowsiness, lethargy, confusion in the mother and “congestion” (the residual effect of the narcotic substance, manifested in the sluggishness of vital reflexes and functions, primarily breathing) at the time of birth in the baby - if pain relief was performed late.
Nitrous oxide
There is another method of medication labor pain relief, until recently widely used in domestic and foreign obstetric practice. We are talking about the use of nitrous oxide, a gas that, when inhaled, reduces pain sensitivity. Currently, this method is practically not used due to low efficiency and a large number of complications (respiratory depression in the woman in labor).
In conclusion, I would like to draw the attention of expectant mothers to this fact. None medical intervention cannot harm – if it is justified. Therefore, before deciding to choose one or another method of labor pain relief, you need to seriously weigh the pros and cons together with your doctor.
Remember that pregnancy and childbirth are not a disease, but the most natural thing for female body state. This means that nature has provided everything in order to successfully cope with this task - so difficult and so happy on your own!
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The fear of severe pain during childbirth scares every woman. It is well known that contractions are accompanied by pain, which intensifies as delivery approaches. However, the pain threshold for pregnant women is different, and if for one it is pain that can be overcome, then for another it is great torment.
Promedol during childbirth
The older generation of women advise the woman in labor to be patient - they say, everyone has been patient and this is the norm. However, isn’t it more advisable to experience the exclusively joyful sensations of the birth of a baby, rather than suffer in anticipation of unbearable suffering?
Pain relief during childbirth with promedol
Promedol during childbirth refers to pharmacological group means that can reduce pain and calm the mother in labor.
TO non-drug therapy The following methods include:
- psychoprophylactic preparation of women;
- pain-relieving massage;
- water procedures;
- certain ways of breathing;
- comfortable poses;
- methods of reflexology and aromatherapy.
If all of the above methods do not have the desired effect, it is advisable to resort to the use of medications.
Promedol during childbirth consequences
The main question that worries a woman in the delivery room is: possible consequences for a child from using an anesthetic drug. You should know that Promedol in its composition is a synthetic analogue of morphine. The substance is considered to be quite safe for mother and child during labor. However, in some women Promedol can cause the following side effects:
- nausea;
- feeling of intoxication;
- staggering.
Speaking about the effect on the child, the drug penetrates the placenta 2 minutes after administration. The concentration of the substance in the umbilical artery is identical to the content in the woman’s blood.
The main disadvantage of Promedol during childbirth is considered to be prolonged removal from the baby’s blood. For comparison, the removal of a baby from the body is 7 times slower than that of a woman in labor.
Accordingly, the side effects of the drug for an infant are drowsiness and respiratory depression. The use of this kind of analgesics during childbirth does not affect the baby’s dependence on such substances in the future. Despite the high effectiveness of the drug, for 35-40% of women in labor the drug provides insufficient pain relief.
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It is very important from the very beginning of pregnancy to begin psychological preparation for childbirth, to tune in to a successful outcome. The doctor who is monitoring your pregnancy can be of great help with this, of course, only if there is complete mutual understanding between you. It is ideal when the same doctor conducts the birth. During pregnancy, you become members of the same team, and during childbirth you will benefit from powerful psychological support.
Types of pain relief
Most often used:
- promedol(a narcotic substance that is administered intravenously or intramuscularly)
- epidural anesthesia(anesthetic is injected into the space in front of the dura mater surrounding the spinal cord)
Does pain management affect the child?
Promedol in the dose that is used for pain relief during labor does not have any effect harmful influence for the fruit. However, the baby can sleep with the mother.
Epidural anesthesia is considered extremely necessary for the gentle management of labor; it makes childbirth less traumatic for the fetus, since the main obstacle that the fetal head encounters during its advancement, the cervix, softens significantly and opens faster.
Which is better: promedol or epidural anesthesia
This depends on many circumstances that only a doctor can evaluate.
But you need to keep in mind that promedol can be administered only once, so it is better to administer it when contractions are strong and the cervix is well opened, since its effect lasts 1-1.5 hours. Promedol does not completely relieve pain, but it significantly reduces the severity of the pain; it is perceived differently.
And with epidural anesthesia, the pain is completely relieved; pain relief can be added through a thin catheter as the pain intensifies.
Epidural anesthesia is performed only by very experienced anesthesiologists who are fluent in this technique, so such a complication as spinal cord injury is practically excluded. A rare but common complication is headache after childbirth, which passes very quickly.
Minuses
Of course, epidural anesthesia has its pitfalls. First of all, this method of pain relief is not suitable for everyone. Contraindications include: allergic reactions to local anesthetics (drugs used in dental treatment: lidocaine - as a local anesthetic it is excellent, novocaine, etc.), poor blood clotting, elevated temperature, neurological diseases, bleeding, obesity, purulent wounds in the lumbar region. Of course, no one gives anesthesia until regular labor is established and in the event that the woman refuses it, preferring to bravely endure the pain. Each woman decides for herself how long to endure and when to turn to professional help. In principle, many women in labor manage to do without painkillers. Some people have a high pain threshold and even the first birth goes easily and quickly. If you can endure it, it’s better, of course, to endure it, anesthesiologists understand this. It would be a mistake to compare epidural anesthesia to a mint candy, which is suitable for everyone without exception and is known to be safe. This method also has side effects and complications. The most common complication is headache, which can last up to three weeks. This is a consequence of unintentional puncture of the hard meninges when the needle enters the vertebra a little further than it should. This happens even among experienced specialists in 1% of cases in the world. These pains respond well to treatment and go away without consequences. Another problem is lowering blood pressure. To prevent this complication, before anesthesia, about 500 ml of liquid is injected into a vein for 5 minutes. Rarely, but it happens that a highly concentrated solution local anesthetic slows down the birth process. Among the others side effects Pain at the injection site (can last up to seven days) and allergic reactions are the most common. Some people are confused by the fact that the use of epidural anesthesia deprives the woman in labor of the ability to move independently. However, many of these disadvantages are still offset by one big advantage: women who give birth without extreme pain often leave the maternity hospital with the intention of giving birth to a second, and perhaps a third, child there.
Ultimately, whether to give birth with or without anesthesia is a woman's personal decision. The main thing is that it is accepted wisely and honestly. No matter how the birth goes, the knowledge that you have somewhere to retreat to, that in no case will you be left alone unbearable pain, is in itself a very powerful calming factor, which allows many to do without the help of an anesthesiologist.
