An injection during childbirth. Modern methods of pain relief during childbirth: medical and natural pain relief

Fear of pain during childbirth is rooted in the soul of a woman from the very beginning, and even after giving birth once, she can continue to be afraid. Why it occurs is understandable, everyone says that there is nothing more painful than childbirth. Someone compares labor pain with fractures of 20 bones at once, someone says that it was the biggest pain in his life.

If you are expecting a baby, you, of course, do your best to set yourself up for positive. Thanks to the availability of information comes the understanding that this is a natural process that should not cause much pain. By the end of the term, you calm down and the desire to end the pregnancy becomes stronger than these fears. But the question of whether childbirth is facilitated still remains. Even the most self-confident person should have hope that if it suddenly hurts too much, they will help him.

Do they give painkillers during childbirth?

Of course, it is possible to make childbirth easy and painless, and analgesics during childbirth in one form or another are now used in almost 90% of women in labor. You can do it in such a way that a woman will simply oversleep them, and she will have to be woken up at the most crucial moment.

Pain medication during childbirth has even become a source of additional income for maternity hospitals; almost everywhere you can get this service for a fee (we are talking about epidural anesthesia). In the antenatal clinic, you can be given a list of things necessary for the maternity hospital, so far it may also contain medications designed to weaken contractions.

You now have plenty of chances to think over childbirth, although from the point of view of what is best for mother and child during physiological childbirth, a birth without drugs is, of course, preferable.

How to anesthetize childbirth

There are several options to make childbirth painless. They differ in efficiency and safety. Another question is whether it is necessary. Sometimes loss of pain sensitivity is vital. For example, if the contractions are strong, frequent, but ineffective, and the cervix does not open.

The following methods are used for this process:

• Physiological. This is a relaxing massage of the lower back, calm music, special breathing techniques and exercises, bath and shower.
• Spinal and - a special injection during childbirth in the spine with the introduction of drugs to the spinal cord. The most reliable and modern method. Such an injection during childbirth begins to act literally after 5 minutes, completely relieving pain.
• Other drugs are also used during childbirth, which are administered intramuscularly, intravenously and in other ways. These are mainly antispasmodics, narcotic analgesics and drugs that affect the central nervous system. Even nitrous oxide (an anesthetic) is used, which a woman breathes through a mask, independently adjusting the degree of anesthesia.
• Acupuncture and other physiotherapeutic methods of influence. Not applicable in all hospitals.

It also happens: at the end of the second stage of labor for about 40 minutes - 1 hour there are very intense, frequent contractions, leading to full disclosure of the cervix. The fatigue that has accumulated over the past hours makes itself felt, there is a strong feeling of pressure on the bottom, the baby presses his head on the cervix and sacral plexus, the head is pressed tightly against the entrance to the small pelvis and there is very little left before the birth of the baby.

A woman who says a firm "no" to any medical intervention may simply break down at this time. It is at such moments that a woman in labor most often screams - do me a caesarean, do at least something, stop it! But right now it's too late to do anything. If a woman in labor is given a medicine that really relieves pain, the baby may have complications after birth, for example, respiratory depression.

And then the necessary injection is given as a placebo. For example, a no-shpa is introduced, which does not have any effect on the uterus at all. This injection is done only to calm the mother, while she will wait for his action - she will have time to give birth.

How to relieve pain during childbirth on your own

The severity of pain during childbirth largely depends on how the woman in labor perceives the birth act. If you resist contractions, tighten up, then your body quickly gets tired and you begin to feel pain. It often happens that a woman initially expects pain during childbirth and thereby provokes its appearance. It's a vicious circle - the more you resist the contractions, the more the pain, the more the pain, the more you tighten up. The uterus is working hard, but the cervix cannot open - you do not let her do it with your fear.

The pain syndrome increases due to the accumulation of lactic acid in the muscles of the uterus and its resistance to itself: some muscles work to open, while others spasm and do not allow to open. Due to the fact that at present, almost all expectant mothers have the opportunity to attend childbirth preparation courses, and you have the opportunity to learn in advance how to anesthetize childbirth on your own.

In the courses, you will learn everything about special breathing and relaxation techniques in childbirth, about exercises that help, you will tune in to the fact that giving birth is not painful, and should not be painful. It’s good if you have a partner with you during childbirth, not necessarily a husband. Even your mother, aunt or girlfriend can act as an assistant during childbirth. She needs to go to these courses with you. Here they will teach you how to make a relaxing massage during childbirth, breathe with the woman in labor, support and guide her at the right moment.

Yes, childbirth cannot be completely painless. Unpleasant sensations, of course, will be. Partly on how much it will be unpleasant and painful for you, you can influence yourself. And remember that if you suddenly can’t cope - there are alternative ways to relieve pain, analgesics are used during childbirth, if you need it, they will help you.

Anesthesia during childbirth helps a woman to more easily transfer the process of the birth of a baby. The development of anesthetic techniques minimizes the risk. Let us consider in more detail the methods of anesthesia during delivery, find out which types of it are preferable, and how to anesthetize contractions during childbirth without drugs.

Do they give pain relief during childbirth?

Childbirth without pain recently seemed impossible. However, the development of medicine allows a pregnant woman to become a mother almost painlessly. At the same time, conditions of maximum comfort are created, which minimize the development of stressful conditions, eliminate fear. The pain syndrome is completely stopped, and with it, fear disappears at a subconscious level.

It is worth noting that anesthesia during childbirth is sometimes a prerequisite. Without anesthesia, delivery is not complete in the presence of chronic diseases. So, doctors alleviate the suffering of a woman in labor, completely relieve emotional stress. All this has a positive effect on the speed of the recovery period and its duration.

Pain relief during childbirth - pros and cons

Not all pregnant women choose easy childbirth without pain. Many speak out against anesthesia during this period. Their concerns are related to the negative effect of the anesthetic component on the fetus. In addition, such pregnant women are confident that a baby born with anesthesia will be less able to adapt to new environmental conditions. However, modern methods of anesthesia completely exclude the presence of these factors.

Recent studies in the field of obstetrics have shown that competent pain relief in timely delivery, compliance with dosages, minimizes the development of complications. Talking about pain relief during childbirth, doctors call the following positive points:

• reduction of pain syndrome;
• exclusion of stress;
• prevention .

But like any medical procedure, an anesthetic injection during childbirth has disadvantages:

• the development of an allergic reaction;
• weakening of labor activity.

Types of anesthesia during childbirth

Methods of anesthesia during childbirth, depending on the means and methods used, are usually divided into:

• non-drug methods;
• medical;
• regional anesthesia.

The choice of anesthesia technique is determined by the condition of the fetus and the pregnant woman. Doctors consider the possibility of using anesthesia, paying attention to:

• gestational age;
• the number of fruits;
• no contraindications in a pregnant woman.

Non-pharmacological methods of labor pain relief

Non-drug pain relief during childbirth completely excludes the use of drugs. At the same time, doctors use various psychological techniques, physiotherapy,. So it is possible to distract the woman from the pain factor as much as possible, to reduce the suffering associated with the process, the expulsion of the fetus. Among the common techniques:

1. Psychoprophylaxis- conducting courses in which a pregnant woman is introduced to the peculiarities of the childbirth process, they are taught to relax, breathe, and strain properly.
2. Massage of the lumbar region and sacrum- reduces pain, helps to more easily endure the period of cervical dilatation.
3. Breathing technique- helps to relax, not so intense to feel the pain.
4. Acupuncture- the installation of special needles in the prenatal period helps to relieve physical stress, prepare the pregnant woman for childbirth.
5. Warm baths- reduce the tone of the uterine muscles, accelerate the process of disclosure, reduce pain.

Medical methods of labor pain relief

As the name implies, these methods of anesthesia involve the use of drugs. An analgesic for labor pain relief is selected individually. It should be borne in mind that such drugs are able to penetrate the placental barrier, so they can be used in a limited way - at a certain period of childbirth and at a dosage prescribed by a doctor. According to the method of administration of the anesthetic, it is customary to distinguish:

1. intravenous anesthesia. It involves the introduction of a drug directly into the general bloodstream, leading to a complete loss of consciousness. The patient is immersed in sleep, while sensitivity is excluded.
2. epidural anesthesia. It involves the introduction of a drug into the region of the spinal cord. As a result, the transmission of nerve impulses from the lower parts of the body is blocked.
3. Inhalation anesthesia. The anesthetic is administered through the respiratory tract.

Medical anesthesia of childbirth has a positive effect on the subsequent rehabilitation of a woman. The expectant mother does not experience fear, emotional stress associated with the upcoming delivery. Modern principles of anesthesia in childbirth have many advantages, including:

• full control of the delivery process;
• no side effects;
• minimal effect on the fetus.

Modern methods of labor pain relief

Modern anesthesia of childbirth completely eliminates the development of complications associated with the use of drugs during the period of delivery. At the same time, the effect of anesthetic drugs on the fetus itself is minimized. This helps to give birth to a healthy child, accelerates the recovery processes of the female body in the postpartum period. Among the common, widely used modern methods of anesthesia:

• pudendal blockade (injection of an anesthetic into the pudendal nerve area);
• the introduction of drugs into the tissues of the birth canal (reduces sensitivity, reduces pain when the baby passes through the birth canal).

Pain during childbirth - epidural anesthesia

Epidural analgesia during childbirth is widespread due to its high efficiency, lack of effect on the baby. At the same time, it is possible to provide the woman in labor with maximum comfort. The drug is injected into the area between the 3rd and 4th lumbar vertebrae. Stopping the transmission of nerve impulses eliminates the sensation of pain. The woman herself is conscious and can hear the first cry of her baby, as in natural childbirth.

However, this anesthesia during childbirth has its drawbacks. Among the main ones:

• incorrect behavior of a woman in labor, who does not feel well during the contraction;
• prolongation of the period of expulsion of the fetus;
• the risk of developing acute hypoxia in an infant due to a strong decrease in blood pressure in the mother.

Intravenous anesthesia during childbirth

Painkillers during childbirth are rarely administered intravenously. This is associated with a high risk of complications. After the use of most anesthetics, there is a decrease in activity, the development of lethargy, which adversely affects the delivery process. In addition, there is the possibility of reducing the tone of muscle structures, which has a bad effect on the process of fetal expulsion: they become mild, have a short duration and intensity.

Natural pain relief during childbirth

When thinking about how to anesthetize childbirth, women often come across natural methods of anesthesia. These methods absolutely exclude the use of drugs, are safe for the baby and mother. Their action is aimed at relaxation. Among those:

• use of music therapy;
• massage of the lumbar region;
• physical activity.

How to prepare for childbirth without pain?

Considering the methods of labor pain relief, it must be said that self-relaxation is an effective method. Having mastered these skills, a woman will be able to alleviate her condition during childbirth. You need to learn this in advance, even in the process of bearing a baby. In order to control your body, you must:

1. Take a horizontal position.
2. Breathing should be slow and concentrated.
3. Raise one leg, then the other, feeling the tension.
4. Clench one hand into a fist, then the other hand.

Feeling the tension, it is necessary to fix the muscles for 5-10 seconds, then relax. This is done with each part of the body, gradually involving the muscles of the back, legs, abdomen, arms, and pelvis. These pain relief techniques during childbirth will help the woman in labor completely relax between contractions, take a break and continue the process. The delivery itself will be less painful, and complications such as rupture of the vagina and perineum will be avoided.

Modern women in labor are more fortunate than their mothers and grandmothers. Medicine is ready to offer them effective ways to reduce labor pain. One of these methods is epidural anesthesia, which is quite widely used both in physiological childbirth and in surgical childbirth.

This article will discuss how such anesthesia is done, what are its advantages and disadvantages, and whether it can have negative consequences.

What it is?

Epidural or epidural anesthesia is a gentle anesthesia method. In order to relieve pain, the patient does not need to be completely immersed in medication sleep. The woman remains conscious, but an epidural injection into the spine deprives her of all or part of her susceptibility in some parts of the body.

The spine is part of the central nervous system, it contains numerous endings of the nerve processes that send impulse signals to the brain. This is how the signal of pain is transmitted. The pain center in the cerebral cortex receives it, analyzes it, and the person begins to feel pain.

The technique of epidural anesthesia lies in the fact that drugs are injected into the spine, or rather, into its epidural space, using a long lumbar needle and a catheter, which block the sending of a pain impulse. As a result, the brain simply does not receive and does not understand signals from certain nerve endings. To anesthetize different parts of the body, drugs are injected into different parts of the spinal column.

In childbirth and during surgical delivery, there is a need to desensitize the lower part of the body, and therefore the injection is made in the lumbar spine.

The nerve roots are washed with a drug - an anesthetic injected through the catheter, their sensitivity is temporarily dulled or disappears completely. In natural childbirth, drugs and dosages are different from those for caesarean section. A woman who gives birth herself thus gets the opportunity to more easily survive labor pains, but a complete decrease in sensitivity does not occur, she feels the lower part of the body.

With caesarean section, there is a need for a longer and deeper anesthesia, therefore, not only analgesics are administered, as in the first case, but also ketamine.

Preparations that are used for epidural anesthesia undergo a special specific purification, the resulting solutions are intended only for spinal or epidural use. Which drug to introduce and in what quantity, the anesthesiologist knows. He repels not so much from the weight of a woman, but from her height.

It is accepted for each segment of the spinal column that needs to be anesthetized, apply up to 2 ml of medication. The general condition of the woman in labor, her pain threshold, and the individual characteristics of her state of health also play a role.

Advantages and disadvantages

Analgesia by injecting anesthetic drugs into the epidural space is today considered a fairly safe method, so it is recommended by the Ministry of Health as a first-line solution in situations where local anesthesia is needed during childbirth or deeper anesthesia as an alternative to general anesthesia during delivery surgery.

All the pros and cons of this type of pain reduction should be taken into account by two specialists - the doctor who delivers or operates and the anesthesiologist. They must take into account the wishes of the mother herself.

So, a woman can always refuse an epidural injection during childbirth or declare her disagreement with this method of anesthesia before a caesarean section. In this case, alternative methods will be applied, which we will discuss below.

The undoubted plus of epidural anesthesia is that it helps a woman to more easily survive difficult times. With a cesarean, a woman retains clarity of consciousness and can see how her baby will be born. The exit from such anesthesia is incomparably shorter and easier than the exit from general anesthesia. The downsides are that epidural anesthesia can be harmful.

Aggravating consequences after the use of such anesthesia during childbirth may be to lengthen the period of childbirth, weaken contractions, which can be dangerous for the child and mother.

Complications, according to statistics, are not so common - about one case per 50 thousand births. For about 15-17% of women in labor, epidural anesthesia does not work as we would like - it is not possible to achieve the desired degree of pain relief, which means that pain susceptibility is partially preserved, which complicates the work of surgeons and obstetricians.

Epidural anesthesia can have negative consequences for women who have problems with hemostasis. Violation of blood clotting can lead to the formation of hematomas in the puncture area with a small amount of blood entering the cerebrospinal fluid.

If anesthesia is carried out by an experienced doctor, there is nothing to worry about. Without significant difficulties, he will be able to determine the exact puncture site and the rate of drug administration. But a negligent and inept doctor can injure the hard spinal membranes, which is fraught with leakage of cerebral fluid, dysfunction of the central nervous system. If the needle goes deeper than necessary and injures the subarachnoid space of the spine, the woman may experience convulsions, she may lose consciousness. In severe cases, paralysis occurs.

After applying this method of reducing pain, women often have a headache, and these pains can persist for up to several months. Most of them go away on their own with time.

The harm to the child from the action of drugs is almost equivalent to general anesthesia. In some cases, there is a risk of palpitations and the occurrence of oxygen starvation and respiratory failure after the baby is born.

Contrary to popular belief that pain relief is a serious burden on the heart, doctors say that the heart and blood vessels of a woman in labor, who was given an anesthetic by lumbar puncture, work normally, stably.

For many pregnant women, this method of reducing pain causes fear. It is psychologically difficult to accept the very fact of an injection in the spine. The most difficult is for those who are shown surgical childbirth. Not every pregnant woman is ready to see all the stages of her own operation.

Who is contraindicated?

No woman in labor can be given an epidural if she categorically objects to it. Therefore, the main contraindication is the patient's own desire. If a woman believes that she can cope with labor pains herself or prefers to lie on the operating table under general anesthesia, she only needs to sign the appropriate waiver.

But there are women who just want to be helped in this way. And here there may be certain obstacles that will not allow doctors to do epidural anesthesia. Absolute contraindications include:

• patient disagreement;
• the presence of a purulent inflammatory process, pustules and a purulent rash on the back in the area of ​​​​the proposed puncture;
• coagulopathy (especially against the background of severe forms of preeclampsia).

Relative contraindications to epidural anesthesia are:

• diseases of the nervous system of a woman, especially those associated with dysfunctions of the spine;
• tattoos at the site of the proposed puncture;
• deformation changes in the back, spinal injuries (in case of injuries in the lumbar region, the injection will most likely be refused);
• hemorrhage (pathological hemorrhages in different parts of the body);
• systemic sepsis in a woman in labor;
• high risk of fetal distress syndrome (during premature birth, when the lung tissue of the fetus is not fully matured).

Women with a high degree of obesity can also refuse according to relative indications. They will not do epidural anesthesia if the second birth occurs with a scar on the uterus - anesthesia can make the symptoms of uterine rupture completely invisible if it occurs.

Such anesthesia is not given to women who have bleeding, and also if childbirth takes place against the background of a decrease in blood pressure, dehydration.

Dangerous epidural anesthesia can be in acute fetal hypoxia. If something went wrong in the birth process, complications began and other obstetric response measures had no effect, a decision is made to perform an emergency caesarean section. In this case, the woman is given only general anesthesia. Also, general anesthesia is recommended if additional surgery is needed, for example, removal of the uterus after a cesarean.

For women with heart failure and pacemakers, such pain relief can only be performed with the permission of a cardiac surgeon. If such a specialist is not available and permission has not been obtained in advance, the introduction of painkillers into the spine may be denied.

Alternatives

If for some reason epidural anesthesia is contraindicated for a woman, this does not mean that she will have to endure severe pain. During an artificial birth (cesarean), a woman will be given general anesthesia, which has no contraindications in principle. In this case, an anesthetic will be injected intravenously, and after such an injection, the patient will simply fall asleep. She will not feel how the anesthetist will insert a tracheal tube into the trachea and connect it to the ventilator.

The degree of pain blockade with this method is very high.

Spinal anesthesia, in which the introduction of drugs is carried out at a deeper level - the level of the subarachnoid space of the spinal column, cannot be considered as an alternative, since the same list of contraindications applies to it.

Intravenous injections of systemic painkillers can be used to reduce pain during physiological childbirth.

During physiological childbirth

Special preparation requires only epidural anesthesia, which is planned for caesarean section. This is a standard preparation for surgery and premedication (sedatives and sleeping pills on the eve of a planned operation). If there is a need to do epidural anesthesia during childbirth, no preparation is required.

The woman is placed either in a lying position on her side with her legs raised, or in a sitting position with her back arched in an “arc”. After that, the doctor performs aseptic treatment of the skin area and proceeds to determine the injection point. Usually, to reduce pain during contractions, a needle is inserted between the first and second lumbar vertebrae. A 16-18G needle is inserted in the sagittal plane.

Once in the epidural space, the doctor will feel the “failure” of the needle and the absence of resistance with further advancement of the catheter. After the aspiration test, the first test dose of drugs is administered (usually Lidocaine or Bupivacaine is used). The catheter remains at the puncture site. If necessary, medicine can be added through it if the woman begins to feel pain again. Therefore, she cannot lie on her back. Contractions will take place in the supine position on the right or left side, you need to change the side every hour.

Anesthesia begins to act 15-20 minutes after the administration of the drug. The duration of anesthesia can be different, it depends on the dosage. Often during natural childbirth, doctors use a technique in which the patient herself regulates the dosage - if pain occurs, she will let the anesthetist know about it, who will administer a "supplement" on demand.

Epidural anesthesia is considered the most desirable, which is administered during preterm labor if the child's condition is stable. It allows the woman in labor to relax and the process of childbirth goes faster. At the first birth, when the pain is stronger and the duration of the process is longer, there is also quite often a need for relaxation with the use of epidural anesthesia.

Regional anesthesia also helps with discoordination of labor, with a sharp increase in pressure in a woman, during natural childbirth, if the baby is large or giant, or during the birth of twins. Difficult and protracted labor also rarely do without such analgesia, it gives relaxation, and this helps to open the cervix.

At the onset of the pushing phase, epidural anesthesia is usually not prescribed. Its main task is to promote the opening of the cervix, and when attempts have begun, this is no longer necessary - the cervix is ​​completely open. In addition, a woman should push and act in close tandem with an obstetrician so that the baby is born faster and without negative consequences for the health of the woman in labor and the baby.

For caesarean section

The average duration of the delivery operation is 25-45 minutes. The very fact of using epidural anesthesia will make the operation a little longer - for the duration of the latent period, until anesthesia works (15-20 minutes).

Because surgical delivery requires deeper desensitization, the anesthesiologist must be sure that the patient is well before anesthesia is administered. The woman's blood pressure and heart rate are measured. A special cuff, which will continuously measure pressure in real time and output data to the monitor, is fixed on the arm.

The position of the body during the introduction of instruments into the spine will be the same as during natural childbirth - the woman in labor will either sit or lie on her side. Directly on the skin of the back, the doctor makes markings with a pencil. The vertebrae between which the needle must be inserted for pain relief during surgical delivery are between the 2nd and 5th lumbar vertebrae. The most acceptable puncture site is determined after the fact and on the spot.

As in the case of anesthesia during childbirth, the skin is subject to careful aseptic processing. A thin needle is passed through the so-called yellow ligament between two vertebrae. As soon as the resistance becomes negative, the needle "falls through", a syringe with a catheter is attached to it. The absence of resistance on the other side of the needle will mean that the entry to the epidural space was successful.

The test dose is administered after hitting the desired point. About three minutes is the primary assessment of the effects of drugs. If there is an effect, the woman begins to feel numb, and she is smoothly and slowly injected with the main dose of drugs.

Surgeons proceed to the operation after the appropriate command of the anesthesiologist. This specialist throughout the entire process of surgical delivery is next to the woman in labor, talking with her, adding the right amount of medicines through the catheter.

Support is provided until the operation is completed. Throughout the caesarean section, the woman's well-being is closely monitored by an anesthesiologist and a midwife.

All this time, a woman can see and hear everything that happens. This provides two great opportunities - to see how the baby is born and to attach the baby to the breast right in the operating room, which is extremely useful for the subsequent establishment of lactation.

When a woman is given an epidural before a surgical delivery, the anesthesiologist is always prepared for general anesthesia. This rule is. It may turn out that the “epidural” will be carried out with an error, it will not work, and therefore at any time the specialist must be ready to give the woman general anesthesia.

What does safety depend on?

The safety of a woman and her child depends on several factors, which it makes sense to ask in advance when choosing a particular maternity hospital:

• the level of qualification and competence of the anesthesiologist;
• the level of training and qualifications of obstetricians and surgeons;
• availability of modern medical equipment in the obstetric facility (needles, dispensers, lumbar catheters, monitors);
• use in practice of modern and safe anesthetic drugs (Naropin, Bupivacaine);
• constant monitoring of the condition of the mother and child.

You don't have to be ashamed of your own curiosity. When choosing a maternity hospital, you should ask all these questions. A woman has every right to know what category of doctor will perform her operation or anesthesia, whether there is modern equipment in the maternity hospital and when it was last changed, what drugs are used for epidural anesthesia.

Why does it still hurt?

In their reviews, many women note that they have not been able to completely get rid of all the discomfort after epidural anesthesia. The official description of such cases and causes is included in the protocol of epidural anesthesia, which is the main clinical recommendation for physicians. So, epidural anesthesia may be ineffective if:

• the operation was started before the complete distribution of the drug in the epidural space took place;
• the initial dose of the drug was too low;
• a mosaic blockade occurs (the drug is distributed unevenly, and one side is anesthetized, while the other is not, or partially loses sensitivity);
• individual lack of perception of the drug (it helps to change the drug to another);
• the young age of the patient (the ligaments in the spine are soft, so getting into them is falsely interpreted by the anesthesiologist as getting into the epidural space, loss of resistance).

The opinion of Dr. Komarovsky

The well-known pediatrician Yevgeny Komarovsky has repeatedly emphasized that epidural anesthesia is a very good modern method for reducing pain. It is highly effective and almost safe.

But the human factor is most clearly manifested in it - if the anesthesiologist is skillful and qualified, the woman's birth will be very comfortable and calm. If the specialist is mistaken, epidural anesthesia can be quite dangerous for the woman in labor and her child.

Price

Often women are interested in whether such anesthesia is paid, whether it is necessary to pay extra for it separately. If the birth takes place in a private clinic, under a contract for the provision of medical services, then the procedure is paid. Its cost balances from 7 to 15 thousand rubles, depending on the region and on the specific clinic. The exact cost can be found out in advance, during the conclusion of the contract for childbirth.

In state maternity hospitals and perinatal centers that accept women in labor under the MHI policy, epidural anesthesia is completely free. It can be applied at any time during childbirth, at the request of the woman in labor or the recommendation of the doctor in charge of childbirth.

Modern women have more options for pain relief during childbirth than ever before. A woman in labor can not only use various natural methods of pain relief. Medications have also become more effective and safer. With such a variety of analgesics as today, the mother-to-be should be well informed.

It is best to study the issues of natural and medical pain relief two months before childbirth. It is not at all interesting to take an accelerated course in acquaintance with painkillers after the appearance of the first contractions. Of course, safe and effective pain relief during childbirth depends on your cooperation with your doctor. However, knowing how to use your brain and body to increase the effectiveness of labor and relieve pain is much more important than knowing which analgesic or which gas your doctor will give you. Below is what you need to know and what you should do to reduce discomfort during childbirth.

Why do you experience labor pain?

Pushing a melon-sized baby through the cervix, which at the beginning of labor is no larger than a bean seed, requires great effort and good elasticity. Muscles cannot contract and tissues cannot stretch without the body knowing about it. Your uterus needs to work hard to do its job during labor.

Contrary to popular belief, the source of pain is usually not contraction of the uterine muscles at all. Pain during childbirth is mainly due to the expansion of the cervix, vagina and surrounding tissues during the passage of the child through the birth canal. During childbirth, the uterus does not push the baby out. What actually happens is that the contractions of the uterus push the muscles of the cervix apart and lift, opening the way for the baby's head. (Imagine how a cowl-neck sweater stretches when you stick your head through it.) The muscles and ligaments in the pelvis are equipped with pressure receptors as well as nerve endings that respond to pain, and therefore stretching these tissues causes a thrill that can perceived as pain, especially if the surrounding muscles are tense.

Like all muscles, the muscles of the uterus do not hurt unless they are forced to do a job for which they are not designed. Tired, strained and stretched muscles hurt, and therefore you need to learn how to help your muscles involved in labor work more efficiently. When a muscle is too tired, its internal chemical and electrical processes are disturbed. These physiological changes cause pain.

Appointment of pain

Why is childbirth so painful? The concept of "Eve's curse" - painful childbirth is every woman's punishment for eating an apple from the tree of the knowledge of good and evil - is no longer accepted as either biblical theology or acceptable post-feminist philosophy. The theory that the pain of childbirth is a rite of passage that prepares a woman for the difficult responsibilities of motherhood is also not popular. Even the most respected specialists in the field of obstetrics and gynecology cannot give a satisfactory scientific explanation for the need for pain during childbirth. Therefore, we again have to rely only on common sense.

Not surprisingly, many women ask for an epidural during their appointment at the hospital. Movies and television often depict pregnancy as a disease to be endured, and childbirth as a crisis point in this disease, when a woman lying in bed should be treated with drugs. Conversely, obstetricians try not to even say the word "pain", instead using a technical term such as "labor pains".

Maybe pain plays a useful role during childbirth? Having given birth to several children and observed thousands of women who endured (or did not endure) labor pains, we made two conclusions about the role of pain in the process of childbirth.

1. Pain performs a useful function.

2. Unbearable pain during childbirth is not normal, necessary or beneficial.

Too much pain is a signal from the body that this muscle group is not working as intended by nature, or something is going wrong and requires increased attention. If you are running a marathon and feeling painfully tired, you take it as a signal that you need to eat or drink water, that you need to change your breathing rhythm or pace of running. You take the necessary steps to restore strength and relieve pain while continuing to move towards your goal.

The same thing happens during childbirth. If a woman in labor feels unbearable back pain, she perceives this as a signal to change the position of the body until relief comes. What's good for the mother is good for the baby: by changing her posture, she allows the baby to move around and find an easier - and less painful - way out. Correctly interpreted and wisely used, pain is a valuable aid during childbirth. Listen to her signals. This is why, in some cultures, pain during childbirth is considered “good pain.”

“Purpose-Designed Pain” is not a fateful “New Age” theory concocted by men, a few virile women, or an out-of-touch scientist who himself

never experienced such pain. It has nothing to do with concepts calling for patience; The principle “without pain there will be no result” does not lead to anything. (Even sports medicine experts no longer believe in it.) Think of pain as a bond during labor: tolerable pain means the cervix is ​​doing its job, dilating just enough for you to push the baby through; pain indicates that you need to make changes in your actions.

How do you feel the pain

To bear the pain of childbirth well, you must understand how the body produces the sensation of pain and how the brain perceives it. If you follow the process of a normal labor pain from stretched pelvic tissues to a cry of “Oh!”, you will understand that you can influence the relationship between how much pain the stretched tissues produce and how it is perceived by the brain.

When a contraction begins, the tissues stretch, and tiny pressor receptors in the nerve fibers are irritated, which send short impulses to the spinal cord. If the surrounding tissues are tense, pain receptors are also irritated. In the spinal cord, these impulses pass through a kind of gateway that delays some impulses and lets others through, which then enter the brain and are perceived as pain. Thus, you can act on pain in three areas: where it occurs, in the "gateway" of the spinal cord, and in the brain where pain is perceived. When developing your own pain relief technique, you need to use a variety of methods that allow you to manage pain in all three of these areas.

Another way to understand the transmission of pain is to think of pain impulses as miniature racing cars. They start from the site of irritation in the pelvic area and tend to get to the parking lot, that is, to the microscopic pain receptors located on the nerve cells of the spinal cord and brain. The more cars in the parking lot, the stronger your feelings. You have the ability to influence the activity of these vehicles. First, you can limit the number of starting cars. To do this, you need to practice relaxation techniques to keep your muscles from getting tired and stressed. In addition, you can use effective body positions during childbirth, in which your muscles do the work for which they are intended. Secondly, you can close the "gateway" of the spinal cord without passing cars through it. Pleasant tactile sensations, such as during a massage, send positive impulses that can block the transmission of pain sensations along the spinal cord. In addition, you can create congestion in the “gateway” by sending too many competing machines into it, for example, impulses from music, from certain mental images, or from back pressure. Lastly, you can fill up the parking spaces in your brain so much that there is simply no room left for pain-bearing "cars." It is this effect that anesthetic drugs have, blocking the zone of pain perception. You can achieve the same effect naturally by using your body's own pain-relieving substances called "endorphins".

In addition, a distraction technique can be used to fill the receptors in the brain and block the perception of pain. In this case, you tend to fill your brain with extraneous images, and focusing on them weakens the perception of pain. These techniques look good in childbirth classes and even work when you practice them in your own living room, but are often useless when the actual labor begins. Concentrating attention on any image requires a huge mental discipline, the achievement of which takes more than one year. For most women in labor, an attempt to distract develops into a psychological stress that puts her on the brink of failure. Our experience tells us that neither the brain nor the body of a woman in labor relaxes when she tries to concentrate on something else to distract herself from childbirth. Managing pain during childbirth requires attention to both the brain and the muscles.

Martha's note: During my first birth, I tried to use a distraction technique: focusing my eyes on one point, breathing at a certain pace, and beating the rhythm with my fingers. But when the pain became so severe that this method no longer helped, I intuitively began to do what brought me relief: I allowed my body to take over and do the work for which it was created. By learning to obey my body during childbirth, instead of controlling it, I relaxed - both mentally and physically.

Development of our own pain relief system

All people perceive pain differently: for one it is “sensitive”, and for another it is “painful”. For this reason, every woman entering the delivery room should be armed with her own pain relief system, as well as a backup plan. Responsibility for lies, first of all, on the mother herself. Birth assistants only serve as consultants. While no amount of books you read and no amount of pre-workout can fully prepare you for what you will experience during childbirth, we are willing to bet that the better informed and prepared you are, the less fear you will have and the less pain you will experience. childbirth. While showing you how to develop a pain management system that is right for you, we will focus on ways to reduce both pain generation and pain perception.

Forget about your fears. Pain and fear are related. The effectiveness of the powerful muscles of the uterus depends on the coordinated work of your hormonal system, nervous system and circulatory system. Fear disrupts all three of these systems. Fear and anxiety cause your body to release stress hormones that counteract beneficial hormones designed to speed up labor and ease discomfort. This leads to increased pain and delayed labor. Fear also causes physiological responses that reduce blood flow and oxygen supply to the uterus. Deprived of a sufficient amount of oxygen, muscles quickly get tired, and tired muscles experience pain. Tight muscles not only hurt, they also have a harder time coordinating to open the cervix enough to push the baby through. Normally, the muscles of the upper segment of the uterus contract, pushing the baby out, and the muscles of the lower segment relax and move apart. This coordinated movement allows the cervix to open, allowing the baby's head to pass through. Fear acts directly on the muscles of the lower segment, causing them to contract instead of relaxing. As a result, the strong muscles of the upper segment of the uterus squeeze the tense muscles of the lower segment and the cervix, increasing pain and slowing down labor.

Let go of your fears before labor begins. Certain fears during childbirth are completely normal, and they are based on anxiety before meeting with pain. However, unresolved fears can have a negative impact on the birth process. Although pain-free childbirth is as rare as painless, you should make an effort to get rid of your fears before labor begins. Here's how.

Specify your fears. What are you most afraid of during childbirth? Are you afraid, for example, of pain, having a negative experience of the past? Or are you afraid of a caesarean section and an episiotomy? Maybe you're afraid of losing control in the middle of labor? Perhaps you are afraid of problems with the child? Make a list of all your fears and next to each item write what you can do to prevent these fears from coming true. In addition, you must understand that not everything is in your control and decide not to worry about what you cannot change.

Ensure your awareness. The more you know, the less you will be afraid. There are no identical births, and even for one woman, all births are different, but they all proceed according to a certain pattern. Between the first contractions of the uterus and the expulsion of the fetus, there are always certain sensations (“contractions”). If you understand what is happening and why, and how you might feel about it, no amount of pain will take you by surprise. Knowing what to expect - and when it will end - helps most women in labor feel confident that they are able to endure childbirth. Good birth preparation courses will help you understand what is happening and why. But no course will tell you exactly how you will feel, because it depends on your specific condition and your ability to help labor. The intensity of the sensations experienced often takes a woman by surprise. Some people don't like it and start to resist contractions, letting fear get the better of them.

Invite a professional assistant. An experienced woman who has given birth herself and who has made it her profession to study the normal sensations of childbirth and how to manage them will be of invaluable help to you during childbirth. This professional assistant will help you interpret how you feel, give you advice on pain relief, and help you understand and participate in decisions made by medical staff.

Surround yourself with fearless helpers. Try to reduce the amount of unnecessary fear in the delivery room. By this time, you probably already know which family members and girlfriends perceive childbirth as “horror” and which do not. Fear is contagious. Never let any of these timid helpers be present at the birth. Do not think that this is the right time to prove something to your mother. If she's afraid of childbirth, it's best to have her watch the video after it's over, instead of being in the delivery room and infecting you with her fears.

Avoid fear-inducing memories. Don't bring baggage from past fears into the delivery room. Childbirth usually brings up unpleasant memories of previous difficult births or even rape. In the midst of the most intense contractions, you can automatically tense up, reacting to memories of events in the distant past. Get rid of the emotional consequences of past traumatic events before the onset of childbirth. If necessary, seek the help of a psychologist.

Dr. Bill's note: Many men, including expectant fathers, have a fear of childbirth. They do not understand what labor pains are, it is very difficult for them to see how their wife suffers, and they are not able to help her. Even the most sensitive and fearless man can be frightened in the midst of the most intense contractions or when the situation suddenly changes. It is helpful to 'vaccinate' your husband against fear so that he cannot infect you. Prepare your spouse for what he will see and hear during childbirth. Tell him what can happen if the process doesn't go as planned. And try not to show your own fear. If he feels that you are not afraid, he is unlikely to be afraid himself. A calm and confident assistant will give your husband the rest he needs and also help him focus on his duties, which are to support you and experience with you, and not protect you from this completely natural process.

Take responsibility for your decisions

Although a painless birth is less common than a newborn sleeping through the night, you are largely able to control the pain - if you are ready for it. Check for the presence of the following factors that affect how painful childbirth will be.

Have you made a mistake in choosing a doctor or midwife? Does he take an active part in your learning process and help you trust your body during childbirth? Does every conversation with him leave you with the feeling that your birth will go well? Or does this person create an atmosphere of fear around childbirth, filling your head with possible troubles and complications?

Do you understand the process of childbirth? Do you know what happens during uterine contractions and what these "contractions" are for? Do you understand how being upright during childbirth or changing positions can affect how you feel?

Are you armed with various relaxation techniques?

Have you brought in a professional assistant, especially if there is a possibility that once labor begins, you will not be able to reach the doctor or midwife you are counting on?

Are you sure that all those invited to attend the birth (girlfriends, relatives and husband) are going to support you and will not undermine your self-confidence with their fear?

Do you understand what technologies (such as electronic fetal monitoring) will be used during labor? Are you sure that you have enough knowledge to take part in making decisions regarding the use of these technologies during childbirth?

Are you aware of the various methods of medical pain relief such as narcotics and epidurals? Do you understand their advantages and disadvantages?

Do you realize how important it is to relax and let your body take the lead during childbirth? Have you firmly decided to take the position that suits you best, instead of straining against labor or becoming a passive patient, spending most of your time in a horizontal position?

You should enter the delivery room after you have fully answered all of these questions. If a woman has her own answers to these questions, then she is more likely to be satisfied with her birth.

Learn to relax the muscles involved in labor

"Relax? Are you joking? During contractions, I feel like a huge truck is driving over my stomach!” So one of our acquaintances told the midwife during childbirth. "Relax" is not a meaningless word thrown by helpless onlookers at a woman doing the hardest job of her life. That is what she must do to help labor activity. Relaxed, she will help the uterus to do its job, instead of opposing it. It is the ability to relax that defines the line that separates the pleasant memories of childbirth, which you will treasure for the rest of your life, from the “terrible story” that you will try to quickly forget.

Why do you need to relax? If you relax all your muscles, and only the uterus contracts, this will reduce discomfort and speed up the process of childbirth. If you have tense muscles in any part of your body, especially your face or neck, that tension is transferred to your pelvic muscles, which should be relaxed during contractions. Pain in tense muscles is felt more than in relaxed ones, and they get tired faster. The chemical changes in tired and tense muscles lower your pain threshold, and you experience more pain than when you work an unresisting muscle. When tense muscles resist the continuous involuntary contractions of the uterus, the result of this resistance is pain. Muscle fatigue quickly leads to mental fatigue, lowering your ability to deal with pain. You lose the ability to evaluate options and make changes in your actions that would reduce your suffering.

Marathon running is hard and long work. Childbirth takes even longer, but the hard work here is done in short flashes, alternating with periods of rest - like a charge and a discharge. Once the fight is over, you must take your mind off it completely so that you can get a good rest. If you don't relax between contractions, you lose the ability to recuperate and function effectively during the next contraction. Over time, the contractions become more intense and take more and more strength. That is why it is so important to relax in order to save strength for what lies ahead for you - for the active phase of labor and the pushing stage, when it will take a huge effort to cope with the most difficult work that you have ever had to do.

Relaxation also allows you to maintain the necessary balance of hormones. As we noted above, two types of hormones contribute to the effectiveness of childbirth. Adrenaline hormones (also called "stress hormones") give your body extra energy, which is needed in situations that require a lot of effort, such as childbirth. These hormones are often described as "fight or flight" and serve to protect the body. The hormone epinephrine is a natural drug produced by the body itself, and it acts as a pain reliever. During childbirth, your body needs enough of these hormones to handle the hard work - but not too much so that you stay calm and your muscles and brain can function efficiently. Stress hormones can even divert blood from the hard-working uterus to vital organs like the brain, heart, and kidneys.

Another group of hormones that help you during labor are natural pain relievers known as endorphins. (The word comes from two parts: endogenous, which means "produced within the body," and ***, a chemical that relieves pain.) These are drugs your body produces that help you relax when you're stressed or relieve pain. These physiological assistants during childbirth are produced in nerve cells. They attach to the locations of pain receptors in nerve cells, dampening the perception of pain. Vigorous physical exercise increases the production of endorphins, and during such intense stress as childbirth, they are automatically released into the blood - if you do nothing to block them. Muscle stiffness blocks the production of endorphins. The levels of these hormones are at their highest during the second stage of labor, when contractions are most intense. Like artificial drugs, endorphins affect different women differently, which may explain why some women in labor experience more pain than others. Endorphins are better than artificial drugs. Instead of the periodic flare-ups and subsequent periods of discomfort that drugs give, endorphins provide constant pain relief during labor and a feeling of euphoria, which women in labor call "natural intoxication." Relaxation will allow these natural painkillers to work. Fear and anxiety can increase stress hormone levels and counteract the pain-relieving effects of endorphins. If your soul is calm, the body experiences less pain.

Endorphins also help you transition from childbirth to motherhood. Their level reaches a maximum immediately after childbirth and returns to the prenatal state only after two weeks. Endorphins stimulate the secretion of prolactin, the calming "mother's" hormone that regulates milk production and psychologically sets you up for the joy of motherhood. In addition, endorphins help you stay calm during pregnancy. Studies have shown that endorphins increase when you laugh. Perhaps the proverb is right: "A cheerful disposition is the key to a healthy body and a strong spirit."

When your mind and body work as nature intended during childbirth, your body maintains a balance of stress hormones and pain-relieving endorphins. Fear and fatigue tip the balance in favor of stress hormones, causing pain to increase and labor to slow down. Relaxing during childbirth, you will be surprised how strong the control of the brain over the body. You will feel relief and the baby will be born faster.

How to relax. One of the criteria for choosing birth preparation courses should be the time taken to teach you how much relaxation is needed during childbirth. In fact, your ability to relax is controlled by your subconscious mind. Reading books and listening to lectures will not help you relax. You should devote as much time as possible to practicing relaxation. Seek additional assistance if necessary. Perhaps individual consultations and classes will help you overcome the “relaxation barrier”. Below are some of the relaxation techniques that both Marta and the women we consult find to be most effective during childbirth.

Relax and don't resist. The principle of "relax and do not resist" is the basis of all the exercises discussed below: relax between contractions and not resist during contractions. These two words must be remembered throughout the birth.

Prepare yourself for relaxing thoughts that will help you follow your body's natural actions. Feeling the beginning of a fight, you should not strain your muscles, preparing for what should happen, but take a deep breath, relax and not resist. Exercises that use this principle will prepare you to say to yourself, "A contraction is coming - no need to resist," instead of "Oh my God, another contraction!"

Practice relaxing with a partner. Get comfortable. Bring a bunch of pillows and teach the head pillow specialist (your partner) where to put them. Perform these exercises in a variety of positions: standing, leaning against a partner, a wall, or furniture, as well as sitting, lying on your side, and even standing on all fours.

EXERCISE 1. Check if any muscles in your body are tense. Furrowed brows, clenched fists, and pursed lips are the easiest to spot. Then practice consistently relaxing all muscle groups - from the top of your head to your toes. Tighten and then relax each muscle group to feel the difference between the two. When your partner gives you the “fight” signal, think: “Relax and don’t resist.” Feel how tense muscles relax.

EXERCISE 2. In the last month of pregnancy, practice relaxing touches more often. Such touching prepares you for the fact that tension is followed not by pain, but by pleasure. Determine what kind of touch and what type of massage relaxes you the most. Relax the muscles of the whole body, as described above. Tighten each muscle group, and then ask your partner to gently touch this area while relaxing the muscles. Thus, there is no need for a verbal command to "relax", which over time causes irritation. Another goal of this exercise is to learn how to relax tense muscles from one touch of a partner to a sore spot. Workout: “It hurts here and there - press hard on this place (stroke, touch).”

Music for childbirth. Music can be a great help in relaxation. Carefully choose tunes that you enjoy and that help you relax. Play this music during home workouts so that you develop a reflex and automatically relax during childbirth at the sounds of a familiar melody.

mental images. A clear mind filled with soothing imagery helps the body relax during labor—at least between contractions. In addition, it enhances the production of labor-accelerating endorphins. Sports psychologists use mental images to train athletes.

Decide in advance which thoughts and images will best help you relax, and several times a day - especially in the last month of pregnancy - practice focusing on them. Thus, by the time of delivery, you will have collected a mental library of short images that you can switch between contractions. The following images help most women in labor: surf, a waterfall, a winding stream, a walk along the beach with her husband. In addition, you can prepare several “pictures” with pleasant memories: meeting your husband, memorable date, making love, vacation.

Imagine what happens during childbirth. When contractions begin, picture in your mind how the uterus "wraps around" the baby and tries to pull itself over his small head. During the dilation stage, imagine that the cervix is ​​getting thinner, and after each contraction, the opening expands even more. Some women in labor successfully use visualization in the next stage of labor, imagining their vagina opening like a flower.

It is necessary to switch from pain to pleasant sensations. Try a technique called “pack the pain.” Imagine pain in the form of a piece of modeling clay, which you need to take, roll into a small ball, wrap in paper and place in a balloon that is torn off your body and floats away into the sky. Do the same with unpleasant thoughts: pack them up and then imagine them floating away. This exercise is especially useful in combination with cleansing breathing during a contraction: take a deep breath, and then exhale the air along with the pain.

During particularly intense contractions, and in between, focus on the rewards ahead of you, not on the pain to endure. Imagine that you are bending down to help the assistant take the baby and put it on your stomach, that you are breastfeeding the baby.

Mental images do not refer to methods of controlling the body through consciousness - in this case, consciousness simply helps the body to act more efficiently. Make sure the mental images are a relaxation tool, not a red herring.

If you are convinced that you can move your consciousness to another planet and get distracted from what is happening with your body, in this case you are in for a big surprise: the contractions can be so strong that attempts to mentally escape will not give any results. It is much more realistic to hope that during childbirth, consciousness will help the birth process, and not hide from it.

I have found that it is best to completely eliminate the word "pain" from my thoughts. When my contractions started, instead of waiting for pain, I imagined that I would enjoy it.

I imagined my favorite dessert and it helped me relax.

Pain during childbirth

One day, after speaking at a meeting of the International Birth Preparation Association, we had the opportunity to talk about the pain of childbirth with experienced mothers who were also childbirth preparation instructors. We realized that they have a very different attitude to pain than women with the first pregnancy, frightened by the scary stories of their friends. During the first birth, a woman is programmed that the pain she will have to endure is stronger than any pain she has ever experienced. She doesn't know what the pain will be like, but she knows it will be terrible. An experienced childbirth instructor - and especially if this woman has given birth several times herself - perceives the pain of childbirth in a very different way. It cannot be said that this pain is stronger than any other - it is simply different. Understanding these differences makes the birth of an experienced woman less painful than that of a woman giving birth for the first time.

Think for a moment of the worst pain you've ever experienced in your life, such as a toothache. It took you by surprise and lasted for several days. She immediately became strong, and no means helped. She didn't pass. You were ready to give everything for a few minutes of respite. Pain during childbirth is completely different:

You know what's going to happen, but you just don't know what you're going to experience.

The pain is not continuous. There are blessed pauses between contractions that can be longer than the contractions themselves - at least in the initial stages. A pause is followed by a contraction lasting from sixty to ninety seconds.

The pain is predictable. You know that in a minute or two there will be another fight.

After a while, you already know what your next contraction will feel like. Perhaps the fight will be a little stronger or weaker than the previous one, but generally similar.

Labor pains intensify gradually, giving you a signal to get ready for the reward - the birth of a child.

You know that all this must end.

When it's over, the most valuable reward in the world awaits you.

When you look at the pain of childbirth in a broader sense, it becomes clear to you that Mother Nature has made it so that labor pains can be endured. Otherwise, would women have children?

The process of childbirth is a very exciting and painful process, which is difficult to endure not only morally, but also physically. Probably, every woman who gave birth during the contractions visited the thought of pain relief. Some say that this is an excellent way to have a normal birth, while others believe that pain relief can adversely affect the health of the baby and the process of labor.

Methods of anesthesia during childbirth

When contractions begin and later, a woman experiences severe pain, which can sometimes provoke a malfunction of the heart, breathing and pressure. For certain indications, anesthesia may be recommended to protect the life of the expectant mother and fetus.

Medical anesthesia

1. Mask anesthesia. With the help of nitrous oxide, a woman is put into a state of anesthesia and thus helps to painlessly endure the period of childbirth, when the cervix opens. The medicine is administered by inhalation by inhalation.

2. Endotracheal general anesthesia. The medicine is injected into the lungs through the trachea and provides long-term pain relief. Also, in combination with this type of anesthesia, artificial lung ventilation is used. The anesthetic consists of several drugs, its use is possible only as directed by an obstetrician and an anesthesiologist. This type of anesthesia is used during a caesarean section.

3. Intravenous anesthesia. Anesthesia is injected into a vein, due to which the woman in labor falls asleep for a short time.

4. Local anesthesia. To reduce the sensitivity of certain parts of the body during labor, a woman can be given an intramuscular injection, which will anesthetize a separate part of the body.

5. Epidural anesthesia. A new and very popular method of pain relief during childbirth. When doing anesthesia of this type, the anesthetist inserts a small thin needle between the vertebrae of the woman in labor and through it injects an anesthetic under the hard shell of the spinal cord. So you can temporarily desensitize those parts of the body that are below the injection site. The method is good because it allows a woman to be conscious and feel pretty good.

The disadvantage of this method is that without experiencing pain during contractions, it is difficult for a woman to maintain labor and contribute to the birth of a child.

6. Drug anesthesia. When choosing a method of anesthesia, you should ask what drugs are used for anesthesia. Previously, narcotic drugs were widely used, which include tincture of opium, morphine, nitrous oxide and others. It is known that they adversely affect the health of the child to one degree or another. In modern medicine, a relatively safe analogue of these drugs is used - promedol.

In addition to standard types of anesthesia, there are non-drug methods of pain relief during childbirth.

Non-drug pain relief

1. Psycho-emotional preparation. One of the most important factors in the fight against pain during childbirth. The fact is that women who know what awaits them and understand how childbirth goes, endure contractions easier and less painfully and control themselves better.

2. Massage. Stretching, for example, the muscles of the neck, collar zone, lower back and back, you can distract a woman from pain in the abdomen and pelvis, relax tense muscles.

3. Reflexology. Acupuncture is considered a fairly effective method of pain relief during childbirth.

4. Hydrotherapy. Taking a warm bath or shower at a comfortable temperature can temporarily relieve pain and ease contractions.

Only a doctor can decide on the appointment of anesthesia during childbirth. There are certain indications for this. But if the obstetrician in the process of childbirth sees that severe and prolonged pain weakens the woman in labor, threatens her health, or that she has a low pain threshold, he must administer anesthesia so that the childbirth process ends safely and the lives of the mother and fetus are safe.