Delivery with epidural anesthesia: indications, contraindications. Consequences of epidural anesthesia. How is childbirth after epidural anesthesia?

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

All women know (some from hearsay, others from personal experience) that childbirth is a very painful process. But medicine does not stand still, and childbirth with epidural anesthesia is gaining popularity every day. What it is? Now let's figure it out. From this material, you can find out what are the indications and contraindications for epidural anesthesia during childbirth? The consequences and feedback from women will also be discussed in the article.

Epidural anesthesia is?

Anesthesia, designed to temporarily anesthetize contractions. The drug is injected into the epidural space (in the lumbar region). He, in turn, blocks the pain. But only for contractions.

The dosage is specially calculated so that all sensations return to the attempts and the birth goes without complications. During the action of anesthesia, a woman can calmly walk or rest before the upcoming birth. An amount of medication is given tothe pregnant woman was conscious, but she did not feel pain. With such anesthesia, a caesarean section is also performed, that is, the mother is conscious at the time of the birth of the child. She can see her baby right away, from the first seconds of his life.

When is it free and when is it paid?

Epidural anesthesia during childbirth is done free of charge only for medical reasons. If a woman asks for anesthesia without the necessary reasons, then she will have to pay here.

What drugs are used?

An epidural can be given with several drugs to relieve contractions or for a caesarean section. Their list is short:

1. "Trimekain". Not used alone, goes in combination with anesthesia. The effect of pain relief comes fairly quickly, but does not last very long (within an hour).
2. "Dikain". It is more suitable for caesarean section. The anesthesia process lasts up to three hours. The drug begins to act 30 minutes after administration. The tool is quite dangerous. If the dose is incorrectly calculated, the body may be poisoned.
3. Chlorprocaine. The effect of the drug is the same as that of "Trimekain", but here additional anesthesia is not needed. Comes as a standalone product.
4. "Bupivacaine". It is popular for pain relief during childbirth. The action after the administration of the drug occurs quite quickly, and the duration is five hours. Its plus, does not have a negative impact on the course of labor. Relaxes the uterus.
5. "Mepivacaine". danger inthat can enter the child's blood. Usually, the effect of anesthesia is no more than 1.5 hours.
6. Prilocaine. The action is similar to Mepivacaine, but it can also reduce the amount of hemoglobin in the blood of the mother and baby.

Before an epidural anesthesia is prescribed for natural childbirth, the doctor must weigh the pros and cons. The specialist should also ask the patient if any medications are being taken, if there is an allergic reaction, and so on. To minimize the risk of anesthesia for the woman in labor and her fetus.

Introduction Options

Depending on what the anesthesia is for, the drug can be administered in different doses. If for a caesarean section, then the entire dose is administered as a single dose. In this case, the vessels of the legs dilate, and the woman will not be able to walk temporarily. But this is not required in this procedure. But it will not be necessary to administer an additional drug. And it will be enough for the duration of the operation.

If for pain relief of contractions, then it is better to administer the medicine in parts so that the woman can move without restrictions. It is believed that childbirth with epidural anesthesia does not pose any danger to either mother or baby.

How does an epidural procedure work?

Injection process:

• The woman in labor should take a comfortable position. It is important. Since in the process of introducing anesthesia, the woman must be motionless. Otherwise, complications may arise. Yes, and the doctor needs good access to the treated area. The procedure is usually done while sitting or lying down.side. The back must be bare.
• Before injecting the drug, the doctor treats the area with a disinfectant solution. And then anesthetizes the area where the drug for epidural anesthesia will be injected. Lidocaine is usually used for pain relief.
• A catheter is inserted into the selected and anesthetized area, through which the drug will be injected. The catheter is removed only after there is no need to inject an anesthetic. Do not administer the entire dose at once. So that a woman can be conscious. Important. If before the introduction of the catheter, a woman feels the approach of a contraction, this should be reported to the doctor. Otherwise, involuntary movement will spoil the procedure and may cause pain.
• Usually, the medicine starts to work after 20 minutes. But it depends on which remedy is chosen. The catheter is removed from the back after childbirth. After that, the woman in labor must spend three hours motionless.

Should I give an epidural during childbirth? This is mainly decided by the doctor. But if the woman in labor believes that she is no longer able to endure pain, and the birth itself is not yet close, then contractions can anesthetize. But you need to remember that then the procedure will be paid.

If a woman begins to feel discomfort during the first dose: nausea, dizziness, and the like, you should immediately tell your doctor. The selected drug may not be suitable.

Not all doctors welcome childbirth with epidural anesthesia, since anesthesia affects the opening of the cervix, and also makes the birth process lessactive. A sluggish delivery can harm both the baby and the mother.

Indications for epidural anesthesia

The birth of a child is a very unpredictable process. Even if the pregnancy proceeds normally, this does not guarantee normal labor activity. What are the indications for epidural anesthesia during childbirth? The doctor may prescribe it in the following cases:

1. Preterm delivery. It is with them that the most painful contractions are. The body is not yet ready for the birth of a child. The pelvic bones are not moved apart, the muscles and birth canal are not prepared. In this case, anesthesia will be beneficial. It helps a woman not to lose a lot of strength on the contractions themselves. And at the moment of attempts, the woman in labor can make every effort to help the baby be born. Muscles after the injection of the drug are in a relaxed state, so it will be easier for the child to move through the birth canal.
2. With prolonged and painful contractions, especially if the opening of the cervix is very slow. With such a course of childbirth, the mother may be left completely without strength for the appearance of attempts. Sometimes the process with contractions can last more than a day - this is not normal, but this happens. Thanks to epidural anesthesia, the woman in labor will be able to sleep and recuperate. And relaxing the muscles will help the cervix open faster.
3. It has been proven that epidural anesthesia during childbirth helps to reduce and normalize blood pressure. Therefore, it is recommended for mothers with high blood pressure.



4. Used for caesarean section (multiple pregnancy, large fetus, orfor he alth reasons not allowed to give birth on their own) when general anesthesia is prohibited.
5. When labor is not coordinated, when the contractions are not regular, the uterus opens sluggishly. Then anesthesia helps to align the birth process. Or maybe the pregnant woman agreed in advance with the doctor about epidural anesthesia as needed. Thanks to the drug, the expectant mother has the opportunity to save energy on contractions, as well as see the birth of a baby by caesarean section.

Contraindications for anesthesia

But, unfortunately, not everything is so smooth with epidural anesthesia during childbirth. Before prescribing it, the doctor must check the woman in labor for contraindications.

• intolerance to the components that make up the drug;
• trauma-induced unconsciousness;
• skin diseases in the back, where the catheter should be inserted;
• allergy;
• problems with the spine (for example, a curvature that worsened during the period of gestation). This will prevent the catheter from being inserted normally;
• if the woman in labor is a minor;
• with overweight pregnant;
• when the pressure is very low (the drug will lower it even more);
• a woman in labor is severely malnourished (low weight, loss of strength, and so on);
• if there are problems with the mental state of the pregnant woman;
• problems with vessels and heart;
• if there is bleeding from the uterus;
• blood clotting problems or blood poisoning;
• pregnant herself refused anesthesia, although it was prescribed by a doctor. Until there isconsent was obtained, they do not have the right to administer the drug.

The last point is extremely important to know for every pregnant woman who decides to give birth with epidural anesthesia. Note that for any indication, the doctor will not be able to start using painkillers until the consent of the woman in labor is obtained.

Epidural anesthesia for childbirth. Reviews and consequences

Any medical intervention has its consequences, both positive and negative. Epidural anesthesia is no exception. What to expect after this anesthesia:

• Maybe a not very qualified doctor may just get caught, or the woman in labor herself will accidentally move at the time of the catheter insertion. Then the tip can damage the vein or nerve ending. The consequences are not always predictable (from headaches to paralysis). Therefore, it is extremely important to take a closer look at the doctor and behave exactly as he advises during the introduction of the catheter.
• Temporary numbness of the tongue and nausea.
• If a pregnant woman does not know she has an allergy to the drug, and the appropriate analysis was not done in the hospital, then anaphylactic shock is possible.
• Possible pain at the insertion site of the catheter, the pain is tolerable, but unpleasant and lasts more than one day.
• If anesthesia during childbirth (epidural anesthesia is meant), was carried out not quite correctly (the dosage was exceeded), then numbness of the legs is possible. This will stop after the drug wears off.
• Wrong dose, downwards, will not give the desired effect of pain relief. But it might beand because of the individuality of the organism, even at the correct dose. In this case, it is impossible to administer the medicine again, poisoning of the body may occur.
• Headache and incoordination.
• Impaired breathing and low blood pressure.
• May have trouble passing urine.

In the reviews, women write that it was impossible for them to endure contractions, it was incredibly painful. Epidural anesthesia during childbirth is usually done at the request of the patient. During the birth of a child, as they say, a woman sometimes simply does not control herself. But before you decide on anesthesia, you need to soberly assess the situation. This is a very important point. Women in labor say that it is worth thinking well, maybe you can do without intervention. Otherwise, various consequences described above may occur.

Doctors' opinion

In the reviews of doctors about epidural anesthesia during childbirth, they write the following: “It is worth carrying out such a procedure only if indicated. Otherwise, you can harm the mother or baby. Otherwise, you should refuse it. During childbirth, it is very important to listen carefully to the doctor.

How does anesthesia affect the baby?

After the injection of the drug, the mother should feel relief. But if a woman in labor begins to show side effects, then they can also affect the child. Difficulty breathing will reduce the amount of air that goes to the fetus. Anoxia may begin.

Also, due to the action of the medicine, the baby willmove more slowly down the birth canal. It could harm him. You may need the help of a doctor to remove the fetus from the vagina. This is another risk of birth trauma.

The best analogue of anesthesia is the correct preparation for childbirth. Good and positive attitude. It is possible and necessary to do gymnastics, which will help the baby be born faster. Only natural childbirth, with the feeling of all the pains, will bring real joy to the mother at the first meeting with the child.

Epidural anesthesia for childbirth. "For" and "against"

Now consider the main pros and cons of such anesthesia during childbirth.

Advantages of anesthesia:

1. Anesthesia relieves pain during contractions, gives the pregnant woman a rest and prepares for childbirth during a protracted birth process.
2. Reduces blood pressure, with its help, hypertensive women can give birth to a baby without a caesarean section.

Cons of epidural anesthesia during childbirth:

1. An unqualified doctor may get caught or a woman may accidentally move when the catheter is inserted. As a result, there will be complications.
2. Possible side effects.
3. It is believed that a mother does not feel her baby after anesthesia. Therefore, the birth of a child does not bring as much joy as natural childbirth.

Tips

After reading all the indications and contraindications, as well as evaluating all the positive and negative aspects of the procedure, we can conclude for ourselves whether it is worth risking the he alth of the child(and theirs) to ease the birth process.

If the procedure is prescribed by a doctor, then it is better to agree here. Epidural anesthesia during childbirth has gained such popularity for a reason. She is really helpful if something goes wrong. And at the same time, the child practically does not suffer.

It is important to take the procedure seriously. If it is known in advance that the doctor will prescribe such anesthesia, it is imperative to choose a good anesthesiologist (if allowed). Discuss everything down to the smallest detail with a specialist. Especially how to behave during the procedure. And most importantly, if there are any contraindications. The doctor must know about them.