PDA and other painkillers during childbirth

Every woman experiences labor pains and the associated discomfort differently. The most helpful support to cope well with the contractions is reliable mental support, such as from your midwife or companion. But sometimes, that is not enough, and the pain becomes too intense for you. Our midwife Sissi Rasche provides you with tips in this article on how to find relaxation again and explains the various medical options to relieve pain during natural childbirth: from epidural anesthesia to nitrous oxide and opioids.

What is an epidural anesthesia?

The epidural anesthesia (EDA) is a Anesthesia , which blocks the transmission of pain signals from the spinal cord to the brain. The anesthetic is administered to you by an anesthesiologist/anesthesiologist via a catheter between the second and fourth lumbar vertebrae – this way, the anesthesia is localized and easily dosed. Usually, you receive the epidural anesthesia after a local anesthetic that only causes a feeling of pressure, during the pause between contractions, while sitting. The effect usually begins after 15 minutes and lasts for one or several hours. You remain with fully conscious, feels the contractions but less intensely, which makes it much easier for many women to tolerate. How effectively the epidural actually works varies from woman to woman; most only feel a tugging and pressure sensation. Even though the anesthesiologist's goal is always to keep you as mobile as possible, it may happen that, due to numbness in the lower abdomen, your freedom of movement and coordination of your torso and legs are restricted. Again, the effect is very individual; most women are able to stand and move even with an epidural.

When will you receive a epidural anesthesia?

"Before you receive a PDA, I want to find out as a midwife what is causing the pain and why you're not coping so well right now. Often, there is a reason for the pain, and it can be improved by, for example, your" Posture "change, have yourself massaged, or relax in the birthing tub," says our LILLYDOO midwife Sissi. "Unfortunately, due to staff shortages, there is increasingly less time for extensive mental support, and a PCEA is requested more quickly. However, the administration of pain medication should in no case be due to a lack of support."

The PDA might be the right choice , when you reach a point where you realize you can't go further : The birth has been taking a very long time already and you have been in labor for hours Contractions , the cervix no longer dilates and you are not able to relax at all, instead increasingly experiencing pain – in such a case, an epidural is a blessing. It provides you with calm and new patience. In some cases, the epidural allows you to sleep again without pain, to regain strength. Labor pains are very intense and every woman processes them differently. For many women, the epidural is a great help, especially when the labor is already very long. The epidural often relieves the pressure in this situation and allows the woman to relax, which, in combination with mobilization, movement, and changing positions during labor, can help the baby settle better in the pelvis without causing you severe pain.

Whether you are during childbirth whether you decide for or against a PDA, you should always consider together with your midwife and your birth team . It is important that you remain open . Many women start to get used to an epidural during pregnancy but realize during labor that they can manage well without it. And vice versa: even if you firmly intend to experience childbirth without an epidural, it is not a failure if you change your mind.

How does epidural anesthesia affect the course of labor?

Negative effects of the narcotic on your baby are not known. However, births with an epidural usually last a little longer. One possible reason for this: many women do not feel anything due to the anesthesia. Pressing urgency . The anesthetist should therefore reduce the dosage in a timely manner.

What are the side effects of epidural anesthesia?

Depending on which anesthetic is used for your epidural, there are different side effects. Your anesthesiologist will inform you about this in advance. Common side effects include:

• Dizziness, nausea, and headaches, mostly due to low blood pressure

• Possibly limited mobility

• Water birth is not possible in combination with epidural

• Disruption of labor activity

• Fever

• Problems urinating

• Very rare: seizures and heart rhythm disturbances

After the birth Could it be that your Muscle coordination is somewhat limited in the trunk and legs. If you experience severe pain, nausea, shortness of breath, or muscle cramps, you should definitely inform your doctor. In addition to physical side effects, some women also experience a feeling of regret additionally, because they did not feel the birth properly. Be sure to share your thoughts with your partner and your midwife.

What other painkillers are available during childbirth?

If methods such as , acupuncture, bathing, and aromatherapy no longer help you, there are other pain relief options besides the epidural, which provide relief and interfere less with the birth process.

Muscle relaxants

"Especially in the early phase of labor, I often recommend women to use antispasmodic medications in the form of" Suppository – they act quickly and are generally well tolerated," says Sissi. Through these so-called Spasmolytics relaxes the muscles of your uterus and your cervix, which relieves labor pains.

Nitrous oxide

The administration of nitrous oxide is possible at any point during labor, but especially beneficial for the final phase. The Advantages of laughing gas for midwife Sissi: "Nitrous oxide can be used flexibly and you still have a good" Freedom of movement . Through administration via the mask, most women are again more focused on their breathing . In addition, you gain a sense of Control , because you can dose yourself and decide whether you want to handle the contraction with or without nitrous oxide. Another advantage is that the gas goes directly into your body and is gone immediately – so it has no effect on your baby." However, nitrous oxide can also Side effects like nausea and vomiting, and it does not work quite as pain-relieving as a PDA or opioids.

Opioids

You usually get opioids intravenous administered via an access. They relieve the pain quite quickly, but can Side effects such as nausea and impaired consciousness. Care is taken to ensure that the medications do not have a sedative effect, so you can actively experience the birth and enjoy the bonding phase. Opioids are generally not just before birth administered so that the medication is broken down before your baby is born. Because like all medications, they are processed through the umbilical cord transmitted. If you receive opioids during the pushing phase, they could impair your baby's breathing and other reflexes. In connection with opioids, you should be aware that they are significantly more invasive than the other pain relief methods used during childbirth.

Whatever you do to cope with labor pains – it is entirely your decision whether you want to experience childbirth with or without pain medication, and you don't have to justify yourself for anything. Trust your gut feeling and don't cling too much to preconceived notions: a birth rarely goes exactly as planned.