Labour pains are actually contractions of muscles of uterus (womb) . It is because of these muscle contractions pain is felt (similar to cramp in our leg muscles) . It is because of these Contractions the baby is pushed down in birth passage and pressure is generated on the mouth ofthe uterus which now begins to open. This gives positive signals to brain to generate more contractions thus increasing intensity, duration and frequency of contractions. With this pain experienced by the lady also increases. This finally results in delivery of the baby.
Experience of delivery and pain experienced by the lady is unigue for her. The intensity of pain felt by her depends on many factors like position & weight of the baby, shape & size of her pelvis, her own mental reaction to pain & its intensity, her own tolerance. Some are just fearful about the pain, some are not ,All this makes the experience unigue for her. It is difficult to predict how one will tolerate the pain at that moment. It is beneficial to prepare oneself by improving one’s stamina and strength of muscles by doing exercise even before pregnancy. You can also do some Breathing exercises and practice some Relaxation techniques also.
As mentioned earlier delivery pains are due to contractions of muscles of uterus. Normally these muscles do relax after each contraction and this helps to maintain good, blood flow towards the uterus and baby. So when labour pains are natural, regular and co-ordinate, they don’t affect baby and mother. But if they are beyond tolerating capacity of the mother, she gets tired and exausted , some times her heart-rate, blood pressure may increase It can cause increased stress on heart in a woman with known heart disease. There are some attentive methods to ease / reduce the pain , like hot fomentation, massage, Relaxing body muscles, Breathing exercises (like Lamaze technique ) ? Hypnotherapy, Aromatherapy, Hydrotherapy etc.
Relieving the pain due to contractions with use of medicine, without stopping the contractions is painless delivery. Most accepted and practiced method for painless delivery is EPIDURAL ANALGESIA. Let us understand the word “EPIDURAL“
As shown in diagram, our back has vertebral column, through which runs the spinal cord-many nerves originate from spinal cord to reach various body parts, and carry sensations, from these organs to brain. The spinal cord has a covering called Dura matter. Between Dura matter and surrounding bone of the vertebrae is a space called the Epidural Space. There are many nerves in Epidural space. For giving Epidural analgesia, Anaesthetist is called who inserts a needle through the gap in between your Lumbar vertebrae. A fine tube is passed through this needle and then needle is removed. Local Anaesthetic drugs are administered through this tube. These local anaesthetics block the nervendings , which carry pain sensation. So with Epidural analgesia- the system carrying pain sensation is blocked, contractions of uterus. Are not stopped. Patient continues to get contractions but doesn’t feel pain.
It is widespread misunderstanding that any injection given in the gap between vertebrae leads to Backache.
The diagram given below should help you understand this.
Exercising you Back muscles and Abdominal muscles (core muscles) will help reduce / stop the backache. Few side-effects like headache, Nausea, drop in blood pressure are rarely experienced by patient. These minor complaints are manged by medications and the patients is monitored carefully for results. The new, advanced local anesthetics and their use in minimal dose has reduced the incidence of risks and complications. All this will be explained to you by your doctor and anaesthetist.
The biggest advantage is reduction in pain. Once the pain is gone, patient gets relaxed mentally and physically and her reaction to pain stops completely. Due to this mouth of the uterus opens little faster and thus time required for delivery also lessens. Pain also produces some chemical changes within the body, which affect blood supply to uterus and baby negatively Once pain is reduced due to epidural, blood supply gets improved again. This is beneficial to some patients and their baby especially when they have some associated conditions.
The lady, once relieved of pain, co-operates very well with the doctors and nurses. Can actively Participate in birthing process and can actually enjoy this memorable moment. Epidural analgesia is very helpful is some pregnant women with associated conditions such as high blood pressure, diabetes, Asthama.
No, absolutely Not.
Even if caesarian is required in a patient who has received Epidural analgesia, the reasons are like, non decent of head, mouth of the uterus not getting opened to required extent etc. In our experience at JMH almost 90 – 95 % of patients with Epidural analgesia deliver Normally, sometimes requiring assistance with forceps or vacuum. So, get scientific information about Epidural Analgesia and get rid of fear about pain of Notmal delivery. This will help you to take informed decision.
