Painless Delivery: Everything You Need To Know
Are you pregnant and anxious about labour? Have you heard about painless normal delivery? Yes, there is such a thing. An understanding of this delivery procedure may give you some peace of mind!
By Dr Kavya Krishnakumar
The way a woman gives birth can affect the whole of the rest of her life. How can that not matter? Unless the woman herself does not matter. — Beverley Beech and Belinda Phipps, birth coach
The experience of childbirth is different for all mothers. Some have it easy, some suffer for long. It has been described in various terms ranging from worst possible agony to total ecstasy. The majority of mothers would, however, agree that delivering a child comes with a lot of pain. In this article know about painless normal delivery and its pros and cons during childbirth.
What is labour pain?
Since the process required a lot of hard work for both the mother and the midwife, to deliver the baby, it came to be known as Labour. It is characterised by regular, painful uterine contractions leading to progressive changes in the cervix. This results in the expulsion of the fetus, placenta and the membranes.
Also read: Healthy Food Choices for Pregnant Women
Labour is divided into three stages. From the onset of labour until the cervix is completely dilated is known as the first stage. The second stage starts after the cervix is dilated until the baby is delivered. The third stage is when the placenta is delivered.
Pain starts in the first stage and gets severe in the second stage. Labour pain is generally felt in the upper abdomen, lower back, midback and thighs. In the first stage, labour pain is due to uterine contractions and stretching of the cervix. Pain sensations are carried by the nerves to the spinal cord. During the ending part of the first stage and the whole of the second stage, the pain is due to distension and traction of pelvic structures. This pain too is carried by the nerves to the spinal cord.
Methods to reduce labour pain
Currently, there are multiple options available for pain relief during labour, but regional anaesthesia is the only method which gives complete pain relief from labour pain. Regional anaesthesia can be given by three techniques:
- Combined spinal-epidural
Among these, the most common being the epidural. In this process, drugs are injected into the different spaces surrounding the spinal cord using a catheter which will block the pain sensation in the nerves temporarily.
How to go about painless delivery?
- Generally, obstetricians will consider epidural or painless delivery option only if the expecting mother asks for it.
- Epidural is given only in active labour ie, once your cervix is dilated.
- Epidural anaesthesia can be given by an anaesthetist.
- Consent will be taken from the mother after which IV fluids will be given. Then the medication will be administered in your lower back.
- You will be asked to arch your back while sitting and stay still for a while. This is done to increase the effectiveness of the epidural.
- It takes a minimum of 20 minutes for the drug to start acting.
- Maternal pulse, blood pressure and foetal heart rate will be continuously monitored.
Is painless delivery safe for the baby?
You might have concerns about the safety of the unborn baby in the process. Yes, epidurals are safe for the baby and it gives complete pain relief which reduces the stress levels of the mother. It helps the mother relax, rest and gives her the strength to take the birth experience forward. When the mother is relaxed, it also helps the obstetrician to take a calmer decision even when the labour is prolonged.
Also Read: 10 Myths And Facts About Pregnancy
Pain relief can be continued post-delivery for medical procedures like episiotomy, suturing and in case of an emergency. If needed the same anaesthesia can be continued. After the baby is born, the catheter is removed, the effects of anaesthesia usually disappear within one to two hours.
Advantages of epidural process
Epidurals are the preferred way of doing painless normal delivery. Following are the advantages of the procedure.
- During this procedure, as mothers are consciousness, you can actually watch the baby being born.
- Epidural is not associated with increased incidence of caesarean sections, headache or backache.
- Epidurals do not have any advert effect on breastfeeding and the mother can feed the child as soon as possible.
- Epidurals are recommended for those mothers who had previous caesarean surgery and wants to go for normal delivery.
- It is also recommended for mothers with medical conditions like hypertension and certain types of heart diseases.
- This procedure is also recommended for those women who are expecting in their late thirties as the ability to bear labour pain lessen during that age.
Disadvantages of epidural process
Most common disadvantages are:
- A sudden drop in the blood pressure which is generally treated with intravenous (IV) fluids.
- In some cases, chances of assisted vaginal delivery such as the use of vacuum or forceps to deliver the baby increases as the pushing sensations of the mother are reduced.
- Sometimes, the drugs don’t act and the mother will still feel the labour pain.
- In such cases, the patient will be confined to the bed and might not be able to walk around.
Who cannot have epidural?
The following persons are not allowed to have epidurals:
- You cannot have an epidural if you have a blood clotting disorder
- If you have any infection at the site of insertion
- If you are on a blood-thinning drug
- If there are any allergies to these anaesthetic drugs.
Is epidural delivery method really painless?
Even after epidural in your lower part of the body, you may still feel the contraction, however, the severity of the pain will not be there.
Where is epidural delivery method available?
Painless labour option is available in most of the hospitals nowadays and there has been a rise in the number of women opting for a painless delivery. Those mothers who dread labour pain should definitely try this option.
Giving birth to your baby is a joyous moment. If you are expecting, discuss the methods of pain relief and the pros and cons of the method with your obstetrician during your antenatal check-ups. Do not let pain diminish your joyous moment.
About the expert:
Written by Dr Kavya Krishnakumar on 31 March 2019.
Dr Kavya is a leading gynaecologist of Chennai.
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