Painless childbirth in analgesia: pros and cons

Epidural analgesia, pros and cons

Giving birth is, or should be, the most natural thing in the world, but pain during labor is experienced differently by every woman, so that sometimes it can be an ally and sometimes an enemy. Here's when to consider epidural analgesia.
It is shortly now, our baby bump is about to burst and the little guy / kicking eager to meet us! We have many fantasies and we create anxieties and fears about "our" birth, reading stories, information, talking with relatives and specialists. So let's do a little thought too epidural. Before deciding, however, let's consider everything: PROS, CONS AND ALTERNATIVE METHODS.

Talking about childbirth means talking about physical pain that has accompanied women since the dawn of time. If until recently it was taken for granted that the woman would suffer the pains of labor and delivery, now there is the possibility of choosing to give birth in analgesia. If for some women the pains of childbirth are the very meaning of giving birth, others would gladly give up the agony of labor. So, given that medicine gives us this possibility, why not inform us and evaluate all the opportunities?

Read also: Pregnancy: four useful exercises to prepare for childbirth

Epidural hurts

My midwife in the birth preparation course claimed that the pains of childbirth are essential! These in fact, different from any other pain, have the purpose of guiding the woman in the path until birth, signaling the onset of labor and its progress; the pains in fact increase as the phases progress and communicate to the woman that everything is proceeding physiologically and well. It seems that the pains of labor are then done on purpose to be tolerated by every woman: in fact, if it is true that with each contraction the pain is very strong and exhausting, it is also true that these alternate with small moments of pause that allow us to catch our breath and regain energy. In addition to this, the pain itself sends the signal to the body to release endorphins, hormones that act as natural pain relievers and also help the child to better withstand the stress of descending down the birth canal, which does not happen in the childbirth in analgesia.

Even oxytocin, the hormone that is released during labor precisely because it arises from pain, is missing and it is therefore essential that it be administered synthetically, leading to an increasingly instrumentalized and medicalized birth. Naturally it is not the suffering of labor and childbirth that makes a woman a mother and mothers who resort to analgesia must not feel "less mothers" because they have not experienced the pain of childbirth! Mothers are born with the birth of our little ones and become day after day, looking after and loving them, trying to give them the better and building a world that suits their needs by not making them adapt to our needs
If all women were properly informed, by the gynecologist, midwife, or by attending a birth preparation course, there would be far fewer requests for birth with analgesia or even requests for a caesarean section. What is certain is that every woman must be free to choose to be able to use anesthesia if she prefers that way but to be reassured about her potential and that is that she can face childbirth without resorting to an epidural, it would therefore be right to talk about painless childbirth, without advising it a priori. 

Often in fact, especially among the youngest or among mothers already on the "door", the epidural is almost a fashion, just hear the friend who made it and immediately orient yourself on analgesia or even, perhaps frightened by the stories of mothers, sisters and aunts, literally terrified by the idea of ​​having hours and hours of labor, feel like excluding this possibility and opting for painless childbirth.

The woman must be aware of being able to cope with childbirth, she must be sure that she has all the potential to face childbirth without external tools and these certainties only give her a lot of information from trained and prepared personnel, who must clearly reveal labor and delivery, none of us expects it to be a walk, but to arrive ready, aware of what will be, of the sensations that will be felt, of our strength, helping us with the various techniques (massages, breathing, etc.), free to be able to move and choose the positions that support the pain, aware that the pain it must cross like a wave, thus learning to welcome it and not reject it, it will certainly help us make a more informed choice and maybe we will want to try to give birth without external help and without risking excessively medicalizing the birth of our baby.

What is epidural

With the epidural, childbirth is no longer natural and physiological but medicalized; it takes place through the administration of anesthesia, carried out through a thin plastic catheter in the epidural or epidural area of ​​the spine and this requires continuous monitoring of the maternal arterial pressure and the heartbeats of the fetus. In women who suffer from blood clotting problems, scoliosis, known allergies to the anesthetic or who have infections in the area that lends itself to the administration of the drug, it is not possible to do it.

• In some cases, where the woman is particularly anxious e scary and would even prefer to have a caesarean section rather than a natural birth, an epidural is indicated;
• In some cases, where labor lasts for too many hours and the mother is at the limit of physical strength and no longer cooperates, intervening with an epidural can prevent a cesarean.
• Also in other cases, where the mother is suffering from certain pathologies, such as heart and / or respiratory failure or at risk of stroke, or where the stress of labor cannot be faced, Epidural analgesia is recommended if not essential.

Often natural childbirth in epidural analgesia turns into piloted birth, that is, the need appears to administer oxytocin or to intervene with instruments to get the child out such as forceps and suction cup and in some cases to intervene with a caesarean section.
The epidural acts by blocking the nerve stimulation of painful stimuli at the level of the spinal cord, eliminates pain, leaving unchanged the perception and skin sensitivity, thus making the contractions feel but without pain.

Epidural, side effects

Sometimes side effects such as fever, headache, problems with ambulation (walking), hypotension (lowering of blood pressure), low back pain and itching occur and are transient, some more important such as resistant headache, urinary incontinence and back pain may instead persist.

When the midwife recommends an epidural

In some cases it is the medical staff themselves who propose to the expectant mother l'analgesia epidurale.

• An example when labor becomes too long and tiring, and the mother shows signs of abating with strong stress that inevitably affects the baby;
• even when the woman absolutely requires a cesarean because she has a real phobia of the fear of vaginal birth, it is recommended to give birth in analgesia, in order to save the surgery;

When to avoid epidural anelgesia

Finding yourself in a comfortable and reassuring environment with adequate assistance, attentive but without being intrusive, leaving the woman free to move and experiment with the positions that best allow her to bear and deal with pain, can be a weapon against pain. epidural. Having company in the delivery room and during labor, being able to choose a loved one (partner, sister, mother) and knowing not to face these moments alone being reassured and supported can be another point in favor.

I pro dell'epidurale

The epidural as a method to combat the pain of childbirth is more effective than other methods; gives immediate relaxation and reduces the production of stress hormones; in case of tocophobia that is excessive fear of childbirth, it is an alternative to caesarean on request.

The cons of epidural

• Medicalize childbirth;
• interrupts the natural production of endorphins useful for the progression of labor;
• it has several more or less serious side effects

Alternative methods of pain relief

There are many useful and effective therapies to combat pain without using analgesics, let's get to know them and compare them to be able to better orient ourselves and be able to make the right choice:

• Childbirth preparation course: these courses that accompany the woman from mid-pregnancy in the path that guides her until the birth of her child, precisely prepare to know and recognize the different stages of labor, from its beginning to the actual moment of birth. The woman who attends one of these courses arrives prepared at the time of childbirth, aware of her abilities and of what childbirth is, and if she has learned the relaxation techniques and is able to put them into action, with breathing and training. autogenic, you will likely go through shorter and less stressful labor, with less chance of this being medicalized.
• Hydropuncture: little known and little used technique, also practiced by midwives, where some selected acupuncture points are stimulated by injections under the skin of physiological solution. It causes a noticeable reduction in pain that lasts up to 2 hours and can be repeated. The expectant mother can move freely.
• Acupuncture: requires the intervention and constant presence of an acupuncturist, uses some points located on the hands, legs and sacral spine, which can be stimulated manually or by electrostimulation. Due to the presence of the needles or the wires of the electrostimulators, the mother cannot move freely.
• Autoipnosi: there are courses for mothers-to-be which, if carried out well, at the right time, help the mother to enter a sort of light trance, which causes labor to live in a state between sleep and wakefulness, significantly reducing pain.
• Water: among the most used methods in our hospitals, immersion in water has a relaxing effect on the entire musculature, and has a positive effect on mood. It significantly reduces pain and shortens the time of labor, in some structures for the expulsive phase the mother is taken out of the tub and a traditional position is chosen.
• Massage: they slightly relieve pain and help the mother to relax, in some centers it is carried out by the midwives themselves, which they also use the Shiatsu or the Tuj-na, which works by putting pressure on the same points as acupuncture