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PAIN RELIEF IN LABOUR

Pain Relief In Labour

Though labour is a normal physiological process, it is associated with some amount of pain. Pain is a very subjective phenomena and dependent on the individual. It depends on many factors like the person’s physical build, her emotional status, her mental outlook, associated and coincidental problems etc.  Since there are so many factors that influences pain perception, pain relief can be achieved by changing some or all these factors.
Labour analgesia was first practiced way back in 1847 when chloroform was used by a Scottish physician called James Simpson. The only problem was that the woman woke up 3 days after the delivery and refused to believe that she had delivered.Later on prominent people like Queen Victoria also did experience “Painless Labour”.
During that time it was believed that to opt for painless labour was immoral. The justification was that labour pain was punishment to the woman for Eve’s indiscretion in Eden. But this is a thing of the past and more and more people are going in for pain relief during labour by either medications or other forms of therapy.

  • Some common methods of pain relief are:
  • Medication  (allopathic).
  • Prepared child birth (Lamaze) including relaxation techniques, breathing exercises etc.     .
  • TENS (transcutaneous electrical nerve stimulation).
  • Hypnosis.
  • Accupressure and Accupuncture.
  • Physical therapy like massage, counter pressure, hot / cold compresses, light stroking.
  • Distraction.
  • Intra dermal injections of sterile water.

Medications

Also called obstetric analgesia and anaesthesia. Various methods by which labour analgesia is induced are: 

  1. Intra muscular (in the buttocks / arms) injections or intravenous injection (in a drip form or through an IV line) of analgesics and sedatives.  Various kinds of sedatives and analgesics are available. All sedatives and analgesics have some side effects on the mother and child. Hence the ones which are most safe and with least side effects will be chosen by your doctors.

  2. Inhalation (gases) agents like Nitrous oxide can also be used but are not so popular now days.

  3.  Local anaesthetics are given during episiotomy      to reduce the pain. The same agents can be given to block the nerve supply to the cervix (paracervical block) and the vagina / vulva (pudendal block). 

  4. Epidural and spinal anaesthesia: This type of medication is by far the most popular or commonly followed method. Both are nearly similar but Epidural is preferred for a variety of technical reasons.
     In Epidural anesthesia / analgesia, a local anaesthetic agent is injected inside the vertebral column in the region of the lower back. This reduces the backache and abdominal pain during labour. The doctor may inject the local anaesthetic by a special needle (single shot EA) or more preferably, pass a thin plastic tube into the vertebral column through the needle. The needle is removed and the plastic tube kept in place.
     Local anaesthetic agent is injected through this plastic tube at periodic intervals depending upon the need of the patient – no matter how long the labour. The catheter is kept for some time after delivery and then removed.
     This can also be used to give anaesthesia during Caesarean section.
     For further details regarding the same, it is best to approach your doctor who can then manage a meeting with the hospital anesthetist, so that all your doubts regarding the technique can be cleared.

Prepared Child Birth:

           Relaxation Techniques | Breathing Techniques

Prepared childbirth teaches you ways to use breathing and relaxation techniques to lessen discomfort and pain.
 It also involves psycho-prophylaxis. It needs your active involvement along with that of your spouse or labour partner.

CHILDBIRTH PREPARTION PROGRAMMES AND CLASSES are now-a-days coming up every where and one can enroll at any one of these recognised classes.

In this method (also called the LAMAZE method), the expectant couple is trained and educated about labour. They are taught that labour is a physiological (natural) process and a positive mental outlook towards pregnancy and labour is developed.
Fernand Lamaze was a French obstetrician who realized the importance of psycho-prophylaxis and preparing women for childbirth. He had observed the same in Russian women. He modified the techniques to what is presently called “Lamaze Method”. It is based, primarily, on the principles of conditioned reflex (remember the Russian scientist Pavlov!)

 It mainly consists of:

  1.  Relaxation techniques
  2. Breathing techniques
  3. Breaking the fear – tension – pain cycle
                                             (first discovered by Dr. Grantly Dic-Read)

This is done by preparing and educating the women regarding childbirth, instilling a positive attitude towards labour and thus removing the “fear of the Unknown”  To this is added the positive effect of relaxing, breathing techniques and other measures of pain relief described in this section

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Recommended:  book
"The new parent"
by author Martha
UTILITY

 

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