How can I have a painless delivery

How can I have a painless delivery?

Labour can be a painful experience, unless analgesia is provided. Nowadays, there are techniques and drugs effectives and safe (available in Centro Materno-Infantil do Norte – CMIN) to minimize this pain while you can stay awake during the whole process of labour and baby’s birth.
At CMIN you can find very qualified professionals that will help you during the labour. This team work is composed by two anaesthesiologists every 24 hours, all the days of the year, that will support the delivery room, the surgery room and the ward.
Every day, from Monday to Friday, it takes place a group conference (Analgesia Conference) at 11 AM with the objective to clarify the methods (including drugs administration) available at CMIN to relief delivery pain and answer questions you should have. The appointment to this medical consultation is done at the external consultation secretary.
If you have any disease or anaesthetic complication background, you should inform your doctor (obstetrician) and, if necessary, he will refer you to an Anaesthetic Consultation, that has the objective to improve your heath disturb.
Epidural is the most effective analgesic technique for pain relief during labour. It allows you to be comfortable without being sleepy at the time of the baby’s birth. It is performed in the lumbar region of the spine. 

Brief description of epidural technique

After a correct disinfection of the back’s skin, it is performed a local anaesthesia in the skin where the epidural needle is going to be inserted. Through this needle it is inserted a catheter that remains in the epidural space when the needle is removed and allows the administration of analgesic drugs (local anaesthetics and/or opioids), during labour.
Since the beginning of the insertion of the epidural catheter, it may be needed to wait until 30 minutes to the pain to reduce and to start feeling comfortable. About 15 minutes are needed to insert de catheter and the other 15 minutes is the time necessary to obtain the effect of the drug.
After the administration of the drug through the epidural catheter, the vigilance of the pregnant woman and the fetus starts.
In some cases, the pregnant woman can walk after the epidural catheter’s insertion.
It may be a cause of paraesthesia in the lower limbs or itch. 
If, for some reason, you need a caesarean, the anaesthetist continues to help you during the whole process, keeping the epidural technique (in this case, a epidural anaesthesia) or using a general anaesthesia, if necessary. 

Myths regarding the epidural technique

- “Epidural analgesia increases the probability of caesarean” - Wrong
This is a old myth that is rejected by the most recent scientific studies done in the whole world.

- “Epidural analgesia/anaesthesia causes pain in the lumbar spine” - Wrong 
The lumbar pain during pregnancy and after delivery is common and is associated to many causes: the modification of the spine’s shape during pregnancy and after delivery; the existence of a hormone in mother’s blood (relaxin); and the inadequate posture of the mother during breast-feeding. Scientific studies show that the probability of having lumbar pain is similar in the patients that were submitted to a epidural analgesia and in the patients that were not.

- “Epidural is harmful to my baby” - Wrong
Epidural analgesia reduces the mother’s stress and allows a better circulation of the blood between the mother and the baby through the placenta. It is responsible for an increase of oxygen delivery to the baby during labour.

- “Epidural prevents breast-feeding of my baby” - Wrong If the puerperal woman has pain, it can be responsible for producing less milk. This way, a epidural analgesia, reducing the pain, contributes to a adequate breast-feeding.

Alternatives to epidural

There are some situations where epidural analgesia is not appropriate to you, such as coagulation disorders or altered platelet count, generalised infection or infection in the place of the needle insertion, some cases of previous lumbar spine surgery and others. If you do not intend to have a epidural analgesia or if you have some disorder that contraindicates its implementation, it can be used other modalities of drug administration. Although they are not so effective as epidural to relief the pain, they will help to reduce its intensity. In these cases it can be administered drugs in two different ways: intramuscular and intravenous. We hope that after this brief reading you are able to feel more enlightened and that, in some way, more prepared to the moment that we desire to be the most pleasant as possible to you and to the whole family.