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Painless delivery...What's that exactly?


In day to day practice, we see that for many Moms to-be, the joy of giving birth is coupled with many fears about labour pains. Most of them hear not so encouraging stories of pains in delivery from friends and relatives. This all makes them very apprehensive. Pain is a part of natural labour process. Pain tolerance in labour varies from women to women. Some moms have low pain thresholds, that they demand ceserean very early in labour.

At this point it is important to stress that there are safe and effective options available for pain relief during labour. Every patient has the right to know about them. Talk to your doctor about your birth plan and pain relief in labour.

Epidural block or analgesia is a commonly used procedure for pain relief in labour. It can be used in patients when injectable painkillers like tramadol offer little relief. The goal of epidural block is pain relief with full consciousness and active participation of patient in delivery process. An anesthetist will explain the procedure to patient. It is given in lower back in a small area below spinal cord called epidural space. The patient is asked to lie down on one side or sit. Skin is cleaned with antiseptic. A local anesthetic agent is injected in skin where needle is to be passed.Then a needle is put in epidural space through which a very thin tube or catheter is passed.There will be little tingling, numbness or heaviness in lower body at this stage. The catheter is then fixed. A mixture of painkiller drugs is then injected through the tube at regular intervals to reduce pain. Low doses are used to minimize side effects. The patient is fully conscious. She can move from side to side but may not be allowed to walk. The pain is reduced significantly. Patient becomes more comfortable. She feels less exhausted. She can use that energy later when pushing is required. At the same time contractions are still felt and pushing is fully possible. Little Pain will also be felt when doctor examines for dilatation. The lower part of birth canal becomes numb and even taking stitches after delivery causes no pain. Simultaneously a injection is started to augment contractions under strict fetal heart rate monitoring. Artificial rupture of membranes at good dilatation also hastens the process. It is also good practice to reduce dose in the end when pushing by patient is required. The side effects which can occur sometimes are reduced blood pressure in mother which slows baby's heart beat, for which good amount of intravenous fluids are given before the procedure. It is best to use epidural at 3-4 cm cervical dilatation and start of active phase when chances of normal delivery seem good. If in any case ceserean is required it can be done through same anesthesia. There are few myths among patients related to this procedure. One that it causes chronic back pain for years which is not true. Studies show incidence of backache in women is no different with or without epidural. Rarely there can be a headache due to spinal fluid leakage which is treatable. Othet myth is that patient cannot feel pain so can't push so it increases chance of Ceserean section. It again is not true as she is fully aware of contractions and can push. It makes birthing experience more enjoyable. Most patients who use epidural block in first delivery ask for the same in subsequent delivery. In our country it is slowly and steadily gaining popularity. The main hurdles in its use are prevalent myths mainly among family elders. A good counseling helps. Expecting a baby???? Have a safe birthing experience to welcome your little one!!!...With very experienced and caring Gynecologist Dr Harita Kothia.

Available pregnancy services.. • Normal delivery • Assisted delivery ( vaccum, forceps) • Painless delivery • ceaerean section with fully equipped OT • Newborn care • post delivery care • breast feeding classes • antenatal / labour preparation classes • High risk pregnancy care Dr Harita kothia MBBS, MS(OBGY), PGDHL Obstetrician and Gynecologist Mobile 8169031979 OPD HOURS Phoenix hospital, Chikuwadi, Borivali West. Mon to sat - 2 to 4 pm Sunday - by appointment - 12 to 1 pm Landline number -02228985670, 71 Siddhi Nursing Home, Ratna Deep,1 Floor, Plot 225,Sector 3, Ambedkar Road, Above Thakkar Dairy, Near Apna Bazaar, Charkop, Kandivali West 400067. Opd timings - Evening - 4 to 5 30 pm Landline- 02228698656 Amee maternity and nursing home Jai Radha Krishna society, near new police station, SV road, Dahisar East Mon to Sat 6 to 8 30 pm Landline number -02228283949 02228282454

Disclaimer - These are the views of a qualified doctor and author. These are general suggestions and do not replace actual check up by a doctor. Any resemblance to anybody is coincidental.

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