Which woman should not apply painless delivery method?

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Nguyen Xuan Tinh - Anesthesiologist - Resuscitation - Department of General Surgery - Vinmec Phu Quoc International General Hospital. The doctor has more than 18 years of experience studying and working in the field of Anesthesia - Resuscitation.
The painless delivery method with epidural anesthesia is a good choice, helping the woman to give birth through the vagina quickly and easily and reduce the risk of cesarean section. However, not all women can have an epidural painless delivery.

1. Methods to relieve pain during labor

During labor and childbirth, with uterine contractions increasing in intensity and frequency, the mother feels pain. This pain sensation varies from person to person. For women with a high pain threshold, it is easily overcome and the labor and delivery will be smooth, no need to use any pain relief method.
Pregnant women with low pain threshold often face many difficulties: fatigue, struggle, anxiety, even fainting. It is these factors that cause many obstacles to the fertility process. So, there are quite a few methods to relieve pain in labor:
No drugs: movement (postures help relieve pain), transdermal electrical stimulation, psychotherapy, hypnosis (Hypnosis - artificial sleep) ), acupuncture, massage - physical therapy, putting the husband next to his wife to encourage his wife during childbirth, practicing during pregnancy with deep breathing methods (there are classes for pregnant women about to give birth on breathing exercises). , push-ups), water delivery... Using drugs: Currently, most obstetrician-gynecology facilities use painless delivery using epidural anesthesia (mostly natural labor is applied) or spinal anesthesia. for pain relief (most apply caesarean section). However, not all women are able to apply painless delivery with epidural anesthesia.

2. Method of epidural anesthesia

When the mother wishes to perform the painless delivery method, the Anesthesiologist will examine carefully before performing the technique. Pre-anesthesia examination was performed before the injection procedure to determine if the mother had contraindications to this technique.
The mother needs to be very calm and keep the position, to facilitate the doctor's anesthetic accurately and especially to reduce the risk of complications. The mother is instructed to sit or lie on her side, the doctor will start to look for the epidural space (between the 2 vertebrae).
Next, the back of the mother is carefully disinfected and a local anesthetic is performed with a very small needle, which helps to reduce the pain when the epidural needle is inserted. Once the epidural space is located, the doctor will insert the catheter and fix it along the back. Anesthesia will be injected through the catheter into the epidural space, labor pain will subside after about 10 minutes. The anesthetic will take effect in about 45-70 minutes. The woman is fully awake and can feel the contractions of the uterus, just no pain.

3. Which woman is not given injections for painless delivery?

Painless delivery with epidural anesthesia is not performed in the following cases:
High fever, infection at the injection site in the back (pustules, skin infections...), acute inflammation, sepsis If you have a blood clotting disorder, you are taking anticoagulants. Allergy to amide-group anesthetics Severe uncorrected hypotension Pregnant women with neurological diseases, spinal diseases (tuberculosis, tumors, tumors...) Pregnant women are bleeding or in an emergency. The case of pregnant women with disc herniation, sciatica, and scoliosis is not an absolute contraindication to epidural anesthesia.

4. When do injections give birth painless?

With the method of painless delivery with epidural anesthesia, when the woman is in real labor, the cervix is ​​dilated from 3 cm or more, the uterine contractions are quite clear and the woman feels pain can start to perform injections. painless epidural delivery. When about to give birth, the cervix dilates from 8cm or more, it is recommended to receive spinal anesthesia.
Before an epidural to relieve obstetric pain, anesthesiologists will examine and evaluate the pregnant woman if she is in the contraindications mentioned above or not. If the mother is not contraindicated, the doctor will advise the mother on how to do it, effectively, then the implementation of acupuncture will be conducted. If performed correctly and indicated, the epidural painless delivery method has almost no effect later on.
Currently, there are many medical facilities that apply epidural techniques to help give birth without pain, but pregnant women should choose a reputable medical facility with highly qualified, well-equipped doctors. State-of-the-art equipment to ensure a safe and quick delivery.
With the maternity package at Vinmec, pregnant women will be examined by doctors, thoroughly checked their health and consulted with their families in advance whether or not to use epidural anesthesia.
Epidural anesthesia is quite safe for mother and baby. The role of anesthesiologist is very important and requires a high level of expertise. At Vinmec, there is a team of experienced and professional anesthesiologists who will help pregnant women experience the safest painless delivery.

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