In today’s day and age, it is rare for a woman to want to experience natural childbirth. Instead, it is automatically assumed that there will be an epidural waiting at the hospital, where she will be able to give birth without any pain at all. However, rarely is this the case.
Women choose to birth with medical intervention because they think they can not or do not want to deal with the pain associated with childbirth. Even women who have a high pain tolerance may not consider natural childbirth because the medications used in today’s modern world are so common.
Types of medications:
• Epidural: The most popular pain medication used during labor, an epidural is given through a needle into the area around the spinal column and generally numbs a mother from her belly button to her knees. Antiseptic is used to minimize the chance of infection, and a small area in the lower back is injected with a local anesthetic to numb the spot; a needle is then inserted into the area that surrounds the spinal cord in the lower back. A catheter or small tube is threaded through the needle into the epidural space, and then the needle is removed and medication is administered through the catheter by periodic injections or continuous dosage.
The goal of an epidural is to provide pain relief rather than bringing on a total lack of feeling; it works by blocking the nerve impulses from the lower spinal segments to decrease sensation in the lower half of the body. The epidural is administered by an anesthesiologist, obstetrician, or nurse-anesthetist while lying on the side or sitting up with an arched back, positions that are vital for preventing problems and increasing an epidural effectiveness.
• IV narcotics/systemic medications: IV narcotics, also called systemic painkillers, allow the mother to be more mobile during labor than an epidural, but they have greater risks to the baby and mother because of the possible side effects. They can be given in the form of a tranquilizer or combined with a narcotic and are delivered through an IV line to the bloodstream or injected into a muscle. They affect the entire body rather than just the pelvic area and uterus and may make the mother feel sleepy but not unconscious.
• Spinal block: Similar to an epidural, a spinal is delivered directly into the spinal fluid in a single injection, making for quick relief that lasts only a few hours.
• Combined spinal/epidural: Often called a walking epidural, this is a newer technique that offers fast and continuous pain relief.
Benefits and risks
When medication is used during childbirth, the outcome varies wildly between different mothers. While some women swear that her pain was completely alleviated by the use of an epidural anesthetic, others have trouble with the medication taking effect and are still able to feel both pain and pressure as if there was no medication at all.
Statistics show that a woman who receives medication during childbirth has a longer labor with more complications than a mother who chooses to birth naturally. However, there are benefits for using pain medications during labor.
For example, a mother who has a very long labor can use pain medication to get some rest before she needs to push. Pain medication can also help a mother relax her body if she is tensing up during contractions so that her body isn’t fighting against labor, and it is also useful in situations where a mother has a lot of anxiety or fear about birth or issues from her past that may affect the way labor is progressing.
Among the disadvantages of epidural anesthesia is that it can cause the blood pressure to drop suddenly, resulting in routine checks to make sure the baby is receiving the right amount of blood flow. There may be a need to be treated with oxygen and IV fluids because of the sudden drop in blood pressure. Epidurals are also known to cause headaches due to a leakage of spinal fluid, along with shivering, ringing in the ears, nausea, difficulty using the bathroom, backache, and soreness at the needle insertion location.
Because an epidural makes pushing more difficult due to the inability to feel contractions as strongly, more medical interventions like Pitocin, an episiotomy, forceps, vacuum extraction, and a Cesarean section may become necessary. Other disadvantages are permanent nerve damage, inability to feel your legs after birth, and trouble with a baby’s ability to latch on during breastfeeding, respiratory depression, and an increase in the fetal heart rate.
Contributed by guest blogger A. L. Jones