More and more mothers are being encouraged to have a birth partner / companion . Birth companions can come in several forms from the partner or mothers relative , to a doula or midwife . For the nonmedical partners , they can attend pre-natal classes to help them know what to do .
Medical Labor Pain Interventions
For some women the non-medical pain management strategies are enough but to the majority of us mere mortals something stronger is probably needed in labor . Enter the obstetricians and the anaesthesiologists .
The most common pain relief medication is an opioid , generally in the form of pethidine . Other examples of opioids used in labor include tramadol , morphine and so on . The drug starts working in about 20 minutes and the pain relief usually lasts for about 2-4 hours . It must be noted that no method other than the epidural completely knocks off labor pains .
The challenge of most opioids is that they may cause the mother to feel nauseous and even vomit , dizziness and so on . If the medicine is given very near to arrival of the baby , the baby may come out flat and have difficulty breathing . Fortunately , an antidote exists in the event this happens .
Laughing gas , given in the form of Entonox can be administered in labor . It is a very good method as it has very few side effects for both the mother and baby .
If you are very scared of labor pains then , definitely I would recommend an epidural . With this method a small catheter ( tube / pipe ) is placed in the epidural space in your back . The use of the catheter gives the opportunity to top up the anaesthesia when it wears off also providing pain relief even after the delivery . Should surgery be required this can continue as the main method of pain relief . This is the potential for completely pain free labor .
The challenge with epidurals is that the urge and power to push is diminished . With most epidurals the mother is still able to move about but the length of the labor can be increased . Also , the baby generally needs closer monitoring . This also affects the second stage of labor and the obstetrician / midwife have to be more patient to await the delivery of the baby .
People with epidurals in labor are more likely to have an instrumental delivery with use of vacuum or forceps to expedite delivery of foetal head . Instrumental deliveries are associated with slighter higher risks of injury to the mother or baby , bleeding after delivery , and other complications ( marginal increase ).
Enter Georgina a young lady who was on her first pregnancy . She had initially come with the intention of having an elective Caesarean section . In typical fashion I explored what her issue was with normal delivery and like most women , she was terrified of the pain of labor .
`I encouraged and counselled her on pros and cons of both normal and Caesarean deliveries and she opted of normal delivery with use of an epidural . She went into labor at 39 weeks and was admitted to the labor rooms . She was admitted in latent labor and had to wait for cervix to reach at least 4 cm dilatation . At subsequent review Georgina was 5cm dilated . The anaesthesiologist was called and an epidural catheter was placed and anaesthesia given .
Georgina coped very well and progressed normally . During the second stage the epidural was switched off and Georgina managed to deliver a bouncing baby girl Skylar who weighed in at 3200g . Georgina reported she would use the epidural again for her next delivery which she did and now has a beautiful baby boy Shawn delivered at 3400g . She did not experience any headaches or backpain after both deliveries .
I leave you with these thoughts and pray you participate in the up-coming elections as we pray for peace and prosperity thereafter !
Dr . Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi . You can commune with her on this or related matters via email at : Drmaureenowiti @ gmail . com .