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Writer's pictureDoç. Dr. Erdoğan ASLAN

NORMAL DELIVERY WITH EPIDURAL ANESTHESIA (PAINLESS DELIVERY)


Childbirth is perhaps one of the most painful situations in life.


Labor pains cause unnecessary pain and physiological stress to the mother, as well as cause the mother to become tired.


Therefore, in recent years, the use of anesthetized pain relief techniques for labor and delivery has become very common.


WHEN IS PAINLESS DELIVERY APPLIED?

It is applied when uterine contractions become regular (birth pains settle), when the cervix thins by about 60-70% and its opening reaches 4 cm, that is, when the contractions begin to seriously disturb the mother. Application before it affects the contractions and delays the birth. If it is late, both the mother will suffer unnecessary pain and the pain will come more frequently, so the expectant mother cannot remain still during the procedure and epidural administration may become difficult.


HOW TO MAKE PAINLESS BIRTH?

It is performed by injecting pain relievers around the dura mater membrane (Epidural area) in the lumbar region.


The expectant mother feels the pressure, the touch, she can even get up and walk, but she does not feel the pain.


There are labor pains and contractions necessary for normal birth, but they do not bother.


The process takes place in 3 stages:



In the first stage, the area to be treated on the mother's back is wiped with an antiseptic liquid (Baticon) and covered with a sterile cover. This is to prevent infection.


In the second stage, the skin and subcutaneous tissue are anesthetized with a very thin needle.


In the third stage, a catheter is placed in the epidural area with the help of a blunt needle (tohy needle) and medication is given.


Especially at this stage, it is very important for the mother to stand still for a few minutes.


The catheter is a thin tube made of a soft material.


When the effect of the first drug wears off, it is placed so that additional drugs can be made.


The outside part of the catheter is adhered to the shoulder with a special non-allergic plaster.


From here, medication can be given from time to time as needed, or a certain dose of medication can be given continuously with pre-programmed automatic pumps.


When the expectant mother feels the need, she can make an additional dose to herself by pressing a button connected to this pump. This is called Patient Controlled Analgesia (PCA).


This catheter is easily removed without any pain when the mother is no longer in pain after delivery.


Since the purpose of applying epidural anesthesia in normal birth is to relieve pain only, strong painkillers are also given to the epidural space with local anesthetics in lower doses compared to cesarean section surgeries.


In this way, since the motor will not be lost, the expectant mother can feel the touch and move her legs even though she does not feel pain.


By keeping the amount of local anesthetic very low, the expectant mother can even walk during normal labor.

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