Medicated pain relief | Pain during birth causes and relief

Medicated pain relief

On the medical side, there are also remedies available for natural childbirth that can make the pain of childbirth more bearable for the woman. For example, epidural anesthesia (also called epidural anesthesia = PDA) or spinal anesthesia is possible. However, many women can manage without painkillers altogether.

In general, every woman should approach childbirth as impartially as possible and see how she copes with the contractions. Medication can still be taken at any time later on.

• Epidural anesthesia: The epidural is intended to make the severe labor pains more bearable for the woman in labor.

  It will not lead to complete painlessness during natural birth, because the woman still has to feel the contractions so that she can actively help in the birth process by pressing in time. In addition, the amount of anaesthetic must not be too high, since otherwise not only the pain but also the contractions will be inhibited. When the epidural is applied, the cervix must already be wide enough open and the contractions must have started sufficiently.

• During the procedure, the pregnant woman lies or sits with a curved back so that the vertebral bodies are as far apart as possible.

  The physician then selects the desired puncture height (usually between the 3rd and 4th lumbar vertebrae), since no spinal cord runs there. However, this is where the nerves for the abdomen and legs are located, which can thus be reached by the anesthetic.A local anaesthetic is injected directly under the skin (so-called wheal) so that the thicker PDA needle does not become too uncomfortable for the patient later on. After the skin has been anaesthetized, the actual PDA can then be performed.

  Once the needle is correctly positioned, the anaesthetic can be injected, which then leads to the anaesthesia of the nerves running there. It takes about 15-20 minutes until full anaesthesia is achieved, as the anaesthetic must first pass through the hard meninges before it reaches the nerve tracts to be anaesthetised. The needle can then be removed again.

  Alternatively, a small plastic catheter can be inserted through the needle beforehand, which can remain there for a longer time. This catheter can be used to administer further anaesthetics or painkillers. This is also possible in the form of a self-dosing pump, which the pregnant woman can activate herself if necessary.

  The effect lasts for about 4 hours after a single administration of anaesthetics.

• A normal birth can be made more complicated by the epidural, for example by inhibiting the contractions. An additional drip may then become necessary and the birth is artificially prolonged. Pregnant women with an epidural often have more problems pushing the baby out than women without an epidural.

  Therefore, the epidural should only be used when the pain is almost unbearable.

• Spinal anaesthesia: The difference between epidural and spinal anaesthesia is only the exact place where the anaesthetic is injected. While in epidural anaesthesia it is injected into the so-called epidural space (space outside the meninges), in spinal anaesthesia it is injected directly into the nerves. The effect is ultimately the same.

  In general, epidural anaesthesia is the preferred method of pain therapy during childbirth. Under epidural and spinal anaesthesia, a caesarean section is also possible.

• Spasmolytics: Spasmolytics are antispasmodic drugs that can be administered to the mother by infusion. The spasmolytic effect helps to open the cervix, which makes the birth easier.

  Spasmolytics are also available in suppository form. They can be re-dosed several times if necessary.

• Pain injection: The pregnant woman can also be injected painkillers directly into the gluteal muscle. This can relieve pain and ease cramps, especially at the beginning of the birth. The disadvantage is that the painkillers can be passed on to the child and can reduce its respiratory drive. However, these complications are usually easy to manage and can be easily resolved by administering an opposing drug.