Epidural analgesia

This article is also available in Italian.

The epidural anesthesia is increasing especially in Italy. Unfortunately that’s not all gold that glitters. There is much talk of epidural, but still too little.
Besides the fact that epidural anesthesia takes away the pain of childbirth through the administration of opiate drugs in the epidural space of the spine and then the mother is in a state of total consciousness; what we known about this technique?

From site www.mipaonline.com:

Epidural analgesia – abstract report Dr. Wagner, neonatologist, epidemiologist,Director Region Europe, “Department Maternal Child World Health Organization.”

Scientific evidence shows that the pain of labor in childbirth increases significantly due to:

• a pain in a place unknown, with unknown people around who follow practices unknown;

• being left alone during pain of childbirth;
• undergo artificial rupture of membranes;
• be subject to induction and augmentation with drugs.

So the woman comes into the hospital already in labor, she is subject to a number of things that increase the pain, the woman is given an epidural and, as result, she feels deeply grateful to the staff that has taken away the pain, pain caused mainly by employees themselves.

The pain is an essential physiological pain because it stimulates the brain to release hormones which, in turn, stimulates the uterus in a delicate process of feedback. With the epidural block this process is interrupted and the physiological distress is slowed or stopped..

And you can not say that the epidural is safe!
In addition to cases of partial or total ineffectiveness of the procedure,
are you aware of the risks for mother and child?

• Fetal bradycardia (slowing of fetal heart rate).
• Reduction of uterine contractility power ( (temporary or not).
• Difficult descent of the fetal body in the birth canal.

Therefore:

• It will be necessary to increase the stimulation uteri with drugs such as oxytocin.

• Increase the likelihood of using suction and forceps to 4 times.
• It doubles the chances of a caesarean section (the WHO recommends that the rate of caesareans is from 10% to a maximum of 15%, while in Italy we are at 38%).

Risks to the mother, the less frequent:

• Tripled risk of death.

• Rare chance of neurological damage.
• Temporary paralysis.

and more frequent:Maternal hypotension (lowering of maternal blood pressure).

• Maternal hypotension (lowering of maternal blood pressure).

• Headache. It can last from several hours to several days and is necessary rest in bed and, eventuality, pharmacological treatment (so you lose the firsts days of joy with your child).
• Allergic reactions to drugs used.
• High fever 38°-40°C.
• Urinary retention..
• Probability of 30% or 40% suffer from severe back pain that persist even after a year in 20% of cases.
• The second stage of childbirth stretches considerably.
• Increased depressive crisis of post-partum.
• Reduces the percentage of mothers who are breastfeeding.
• More difficulties in the relationship with the child (because the mother-child bond it was not immediately established).

Risk to the baby:

• Risk, from 8% to 12%, that maternal hypotension causes a reduction of placental blood flow that can lead to severe fetal hypoxia (lack of oxygen that can lead to brain damage or worse, to death).

• Minor neurological dysfunction in children whose mothers have had an epidural.
• Suffering respiratory and premature delivery, both leading causes of neonatal mortality.

Unfortunately it seems that the woman is encouraged to choose the epidural from the medical staff.
You think that some research has shown that even doctors prefer the epidural because it makes women more submissive.

Without considering that frequent use epidural analgesia in physiological shares has created a new specialization, the “anesthetics midwife”.

Not that this is just a source of profit?

For a pain more tolerable, it is important to find the right position, this will also reduce the time of labor and to avoid a caesarean.

Giving birth in water really helps a lot to reduce the pain (I have tried and I think also a 50% less).

For more information please also see www.epidurale.it.