Pregnancy / Childbirth

Epidural anesthesia during labor - a good decision?

Epidural anesthesia during labor - a good decision?

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Increasingly, future mothers choose the place where the delivery is to take place, taking into account the possibility of obtaining epidural anesthesia on request. Many hospitals charge additional fees for this service, for which patients, fearing childbirth pain, spend money. Can epidural anesthetic be called a miracle cure for all evil? In a word: decide or not?

Reading many leaflets and articles for pregnant women, I have the impression that the subject of ZZO (epidural anesthesia for short) is not exhausted, and often discussed only from the perspective of pain relief.
Many mothers, when making the decision to set up ZZO, do not really know what they are choosing, what are the possible complications. Women giving birth mainly think about the promise of total pain relief.

I would like to present ZOP in a slightly different light. Not to frighten ... This is definitely not my goal. However, I believe that every patient should be aware of what she is choosing. There is no "golden mean" in obstetrics that has no flaws.

Why so?

Why do patients decide on ZZO? The answer is simple and basically one. Patients decide to have epidural anesthesia because childbirth hurts. By injecting an anesthetic into the space in the spine, we endure pain and reduce sensation in the lower body. Thanks to this, birth contractions do not hurt and the woman giving birth remains fully aware of what is happening. In addition, studies show that the anesthetic only slightly penetrates the fetus and does not affect the respiratory center of the brain. Thanks to this, babies born with epidural seizures usually do not have problems with catching their first breath.

Why not?

At the beginning it is worth mentioning the "technical" problems. In many hospitals, ZOP is simply not available, in others it costs a lot. Remember that midwife will not give you epidural anesthesia. This is not an intramuscular injection or drip. Epidural anesthesia involves the insertion of a thin catheter into the intervertebral space of the spine. This catheter is inserted by an anesthesiologist (the one who anesthetizes patients for surgery). What does this involve? Very often, when a patient asks for epidural anesthesia, it is impossible to perform it due to the lack of anesthesiologists who just anesthetize the patient for surgery and cannot leave him alone. It happens that an anesthesiologist will not be able to come to the delivery woman until the end of delivery.

Patients often do not realize that ZZO is not assumed from the beginning of delivery. Too fast administration of drugs may hinder delivery, while drugs given too late may simply fail to work. ZZO is therefore usually assumed when the patient has a 5-8 cm gap. It is worth paying attention to the fact that the stage of delivery in which the neck opens from 0 to 6 cm is slow, and the subsequent opening usually occurs much faster (therefore, there is usually no point in establishing ZOP with a large opening).

Epidural anesthesia basically completely excludes the concept of natural or active labor. A patient who has been given ZZO will not take vertical positions and will not give birth in water. The reason is simple - the patient has no feeling in her legs. So she stays in bed throughout the whole delivery. The theory that one intervention involves another is well known. Often, continuous lying down gives birth to pressure on the veins (inferior vena cava compression), which in turn reduces the supply of oxygen to the uterus and the fetus. On the other hand, the toddler reacts to a decrease in oxygen concentration ... by a decrease in heart rate and passing tar. This situation often causes complications and is the cause of Caesarean section.

In addition, the abolition of pain very often means that women giving birth (especially those giving birth for the first time), without feeling pain, do not know at what stage of labor they are and do not have a pressure reflex. This is the reason for a significant increase in surgical deliveries (tick-borne and tick-borne), as well as cesarean section in patients who have received ZZO.

What is the alternative?

Many studies confirm the impact of good physical and mental preparation for childbirth in reducing the need for pharmacological painkillers. In addition, I believe that you should always use methods that are least burdensome.

It is worth starting with non-pharmacological methods (massage, vertical positions, water immersion, compresses), then you can try pharmacological methods - such as relaxants or laughing gas, and only in exceptional situations ask for epidural anesthesia.

One wise man once said that everything is for people. This is also the case with epidural anesthesia. Let's remember, however, that this is not a medicine for all evil and, like everyone, it has its drawbacks.