> Give birth with an epidural, what do you think Vitadidonna.it

Better to give birth with an epidural or without? Better to give birth with pain or without pain?  The question in this way leads to only one possible answer.

None of us wants to suffer, on the contrary we suffer as più possible and consider the pain as a great progress of medicine. Even without abuse, all of us have used a painkiller in any occasion.

an epidural is performed during a spontaneous labor, is a methodology that represents a medical intervention and, therefore, must necessarily be based on accurate information and in-depth and takes into account the advantages and disadvantages.

This technique causes alterations of labor and birth?

Not always, in many cases, there are no unpleasant effects, and indeed is a help to labor and childbirth. There are also some side effects that is good to evaluate:

  • Often, the contractions diminish and it is necessary to use oxytocin synthetic intravenously.
  • You have to check the più often the cardiac monitoring fetal therefore the mobilityà è reduced.
  • Può be a lowering of the sudden pressure.
  • opioids often cause an itching spread.
  • Può happen not to feel più the urge to urinate and there is a need for a bladder catheterization.
  • Può happen to feel my legs “asleep”.
  • The feeling of having to “push” is muted.

What are the side effects for the health of the mother and the newborn?

we Report here the opinion of an authoritative anesthesiologist of our knowledge, that shows us some possible side effects:

    the

  1. puncture injury of the dura mater: an extremely rare but possible, does come in the majority of cases a terrible headache for several days but then usually goes alone.
  2. the

  3. Hematoma, epidural: rare, is due to alterations of coagulation that forò are usually controlled before, or particularly bad luck. The incidence calculated is less than 1 in hundreds of thousands.
  4. the

  5. Infections mater, more theoretical than anything else.
  6. the

  7. Slow-down of the expulsive phase: in this case, there are serious studies, può be that is not true at all.”

it Will haveò stay in bed during labor and childbirth? To succeedò to feel good about the thrust? Canò give birth in the position that I want?

If the dosages are a little più high (but if done correctly does not happen) not è più can walk and stand on feet, this can; cause a slowing down of labour, and a lengthening of the expulsive phase.

do Not è easy to assume vertical positions for the birth and stay crouching può become difficult.

If the dosing is correct for the perception of thrust is absent or very decreased, and this leads to an increase of the operating (suction), and the maneuver Kristeller (push the belly); in this last case, è almost" impossible to avoid recourse to the episiotomy.

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When is better to do? better from the beginning of labor, or to wait and see how it goes?

The expert anesthesiologist recalls that “the epidural is a an analgesic technique, which canò be followed both at the personal request (and in this case, the consent must be signed prior to, together with the necessary information), that the indications of the medical

Therefore, in the delivery dystocico (cio is in the labor, along with a dilation of the neck of the uero slowed down) può have a therapeutic function. In fact, if the woman is too scared può to enter a state of tension and anxiety. Thereò could lead to an increase in the pain, a reduced production of endorphins, a stiffening of the neck of the uterus, making it, così, the labor unnecessarily long and painful.

In these cases, the epidural leads to a muscle relaxation in addition to improvement of fetal well-being.

the labor is induced by administering oxytocin or prostaglandins è più difficult to deal with a spontaneous labor and può benefit from an epidural analgesia.

A friend has a bad memory of his birth, the epidural may help me to have a different experience?

Unfortunately, often the care in our hospitals and highly medicalized and invasive, without any respect for the person; and può happen that is not recognized, no competence to the woman who is treated like a little girl unconscious and you can; have the feeling not to be più the “master” of our body.

If the management of labor and childbirth is very directive and authoritarian with the imposition of the lying position during labor and the expulsive phase, monitoring cardiotocagrafico continues, amniorexi (rupture of the bag) of routine infusion of oxytocin , the labor può be very, very hard and an epidural is certainly help.

But the choice should not be between a birth violent (which none of us rightly is unwilling to deal with) and a methodology, which certainly has its valid application in some cases, even if not free of side effects.

they told Me to do a visit anesthetic in pregnancy…

The anesthesiologist reminds us that “The interview serves to make it clear to the mother what are the risks and complications related to the epidural which is a technique of anaesthesia that can; lead to some complications also series. We intervene to modify the physiological evolution of childbirth by removing the component of pain. If the dosages of the medicines are incorrect or not compatible to your clinical conditions, the newborn is at risk of respiratory depression , even serious. No technique of anesthesia is devoid of complications”. And on the complications still add “Often the women say they continue to have pain in the spine, a few states in the lumbar sciatica chronic etc.”.

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another expert adds: “as a medical procedure and like all procedures not free of potential complications, it should be made to sign an informed consent. Informed means having informed, so esausistivo the woman, and then given time to think and then decide. This is done before active labor. The exception of può be , theoretically, made perhaps, if the request for analgesia is the gynecologist for medical reasons, and in the absence of a signed consent first. (…) This is becauseé then no one can say “but I don’t know…I do not è been told”.  

The anesthesiologist adds: “Every medical practice or surgery has risks and can have complications. For each practice should be made to sign an informed consent. Informed means that should also explain the complications. Is the right to do this becauseé a person can; also choose not to want to deal with the , albeit rare, or very rare, the risk of complication. This does not mean that the signing is taking responsibilityà the woman or the patient, becauseé each of the responsibilityà è always and only our own, but caution is undergoes both who is doing the intervention, becauseé the information has been made and then one can notò say “I did not know”. In the literature, are described in a recent article that analyzed all studies from 1966 to 2005, 6 cases of hematoma, epidural in obstetrics, 3 of which have faltered in neurological problems are permanent. It must not be made of any terrorism, but you should know that there are neurological complications , although exceptional.”

with Regard to possible complications for the fetus we present this study published in an authoritative scientific journal.

There are other solutions, in addition to the epidural, which can help me to have less pain and facilitarmi the birth?

Yes, to give birth in a place where there are some protocols hard to make sure personally the type of approach used. Special attention deserves the figure of the midwife who should carry out the task of supporting the woman , all the while respecting the individualityà and by searching the più possible to create an atmosphere and not to impose its own model or willà on the woman.

The midwife must have the abilityà empathic to promote labor and ease childbirth. This means that a woman has the right to be informed of any practice or therapy, and also the right to give consent or to refuse it . The right to move around freely during labor, choose the location of the birth. The right to eat and drink if they want to.

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Maybe toò the epidural, I can try to reduce the side effects that it has on the labor?

The epidural , as explained above by medical doctors, anesthesiologists, può lead to some side effects (severe ones in really rare), but not for this, we can’t choose our birth, if we wish.

it is important to speak with the anesthesiologist in detail of all the side effects in both visit in pregnancy with the anesthesiologist who will meet in labor. The epidural in some cases, può be of great help and relief. The important thing is that the woman can be correctly informed and free to choose.

The council of the midwife: Keep moving (not for the whole duration of labor clearly, rest when we feel the need is also important) without staying too many hours without a bed otherwise the labor progresses slowly.

If you feel your legs più “sleeping” the use of the ball, pilates classes allows an excellent mobilityà of the basin without getting tired unnecessarily (make sure if the hospital has più of a altriementi better get hold of their own).

Also to the expulsive phase è più fast, efficient, with better outcomes for the health of the mother and the child, try to avoid staying long in the lying position but to seek a vertical position, or squatting, in order to facilitate the descent of the child. Keep in mind that the cot from birth has been invented for the convenienceà of health care workers.

to Have reasonable expectations and keep in mind that the first part of labor (until the contractions are regular , intense and there is increased dilation of the neck of the uterus) is never covered by the epidural, so in the first part the contractions feel still can; help to choose our way of giving birth.

Gabriella Pacini

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See the experiences of Service Anastesia and Analgesia in Obstetrics, Ospedale S. Pertini, Rome

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Page updated on November 30, 2014