Advice From Experts For Painless Normal Delivery

Stating that "Epidural" birth is a very successful and safe method today, Private Imperial Hospital Obstetrics and Gynecology Specialist Opr. Dr. Filiz Tanrıkulu said that "Epidural" birth is accepted as the gold standard all over the world.Advice to expectant mothers, Dr. Tanrıkulu warned about the methods to be used to reduce labor pains and said, "Even though being a mother is one of the most special and beautiful experiences in a woman's life, many women who are preparing to become mothers may feel quite nervous and anxious due to the fears caused by labor pains. Efforts to reduce labor pains were first encountered with the application of chloroform at the birth of Queen Victoria in 1853. For this reason, painless birth is also called princess birth among the people. After this date, the search for reducing labor pains has increased and many methods have been tried for expectant mothers to pass this process more comfortably. Today, epidural birth is accepted as the gold standard for painless normal birth all over the world because it is a very successful and safe method.What other methods can be used to reduce labor pains?Noting that many methods are used to reduce pain during labor, Dr. Tanrıkulu said, “Methods such as hypnosis, acupuncture, aromatherapy, various exercises, breathing exercises, sniffing anesthetic substances, applying some painkillers, numbing some nerves that cause pain with local anesthetic drugs and application of TENS are used to reduce the pain felt during labor. However, these methods are generally insufficient to reduce labor pain. The most effective method known to reduce labor pains is epidural analgesia.

Very low side effectsStating that epidural analgesia has very low side effects when applied by experienced physicians, Dr. Tanrıkulu said, “When epidural analgesia is applied by experienced anesthesiologists, it has an extremely high success rate and has extremely low side effects. Looking at the statistics, it was observed that the desired effect was achieved in 85% of pregnant women with epidural delivery, a partial effect was observed in 12% and no effect was observed in 3% of pregnant women.What is the difference between epidural analgesia and epidural anesthesia?Explaining the difference between epidural analgesia and epidural anesthesia, Dr. Tanrıkulu said, “Epidural analgesia and epidural anesthesia are not the same. These two applications should not be confused with each other. While epidural analgesia is applied in epidural delivery, epidural methods used in cesarean delivery are called epidural anesthesia. Analgesia means painlessness. Anesthesia means insensitivity. With epidural analgesia, pain is not felt while the sense of touch and mobility are not hindered. In this way, it is possible for patients to get out of bed and walk after delivery. In epidural anesthesia, on the other hand, the dose of the drug given is increased and the senses are completely destroyed. In case the normal birth cannot be continued for various reasons in the normal birth follow-up that starts with epidural analgesia, cesarean delivery can be performed by increasing the dose of medication given through the epidural catheter.Can the mother decide on epidural delivery alone?Noting that epidural delivery should be decided together, Dr. Tanrıkulu said, “The epidural delivery should be decided together by the obstetrician and gynecologist, the expectant mother, and the anesthesiologist.Can the epidural method be used in all normal deliveries?For epidural normal delivery, first of all, the mother must consciously agree to participate actively in the birth process. Moreover; Epidural delivery can be preferred if the pregnancy period has passed without any problems, there are regular labor pains, the cervix is ​​dilated 4 -7 cm, there is only one baby at head presentation, and there is 38-42 weeks of pregnancy.

What is the epidural catheter insertion process like?Giving information about the epidural catheter insertion process, Dr. Tanrıkulu, “Epidural analgesia; It can be described as preventing the feeling of pain in the lower part of the waist by administering anesthetic medication through a catheter inserted into the area of ​​​​approximately 0.5 cm called the epidural space outside the membrane (dura) surrounding the spinal cord with the help of a special needle from the waist of the expectant mother. First of all, the general condition of the expectant mother, examination, tests and the condition of the baby are evaluated by the obstetrician and anesthesiologist in terms of suitability for epidural delivery. When it is decided that the patient is suitable for the procedure, the anesthesiologist will explain the procedure to the mother and possible side effects. Your mother's questions, if any, are answered. Consent is obtained from the mother for the procedure. Before the intervention, the mother is given a serum, her blood pressure is measured, and the heart sounds of the mother and baby are connected to the monitor for monitoring. The expectant mother lies or sits on her left side, rests her chin on her chest, crosses her arms over her shoulders, and bends forward as much as possible, arching her back. A good position and standing still are very important for the procedure to be done quickly and effectively. For this, it is of great importance to have constant verbal communication with the mother and to comfort her by explaining what has been done step by step. The lumbar region is cleaned with an antiseptic solution, covered with sterile perforated green, and the procedure area is anesthetized with a local anesthetic drug using a fine needle. After the area is numb, a special needle is inserted into the area known as the epidural space. At this time, pain is not felt or felt very little. Under the guidance of this needle, a long, plastic tube called a catheter is inserted into the epidural area and the needle is removed. Then, the catheter is fixed to the back with the help of a plaster so that the catheter does not come out. The processing time is on average 5-10 minutes. After the procedure, lying on your back and moving do not damage the catheter and the catheter is not felt. Sometimes during the procedure, a nerve may be touched while the needle is being applied. When this happens, some movements, which we call jumping in the leg, may feel electrified or a pain.”

What is the epidural delivery process like?Giving information about the epidural birth process, Dr. Tanrıkulu said, “The administration of medication through the catheter starts when the active birth process begins, that is, when uterine contractions become regular and can be felt by the mother, and the cervix is ​​opened at least 4 cm. The time of administration of the drug is important. If the drug is given too early, the birth will start late and the delivery time will be longer. If the drug is given later, the pain will become more frequent, so it will be difficult for the mother to stay still and to administer the drug. At this stage, serum is applied to the expectant mother. The blood pressure, pulse and oxygen level in the blood of the expectant mother are monitored throughout the delivery. Since there may be sudden drops in blood pressure as a side effect of epidural analgesia, 2-3 liters of serum and fluid are added to the mother during the delivery process. 15 minutes after the drug is applied through the catheter, the expectant mother begins to see its effect and not feel pain. If the catheter remains attached and pain begins to be felt during delivery, an appropriate amount of additional anesthetic drug is continued to be administered with the help of the catheter during delivery. The purpose here is; the mother does not feel the pain but feels the contractions and thus actively contributes to the birth process by pushing when necessary. If the mother feels the contractions are insufficient, the healthcare professionals who assist the delivery can follow the contractions by connecting the patient to the device or by manual examination and tell the mother the right time for straining. When delivery is completed with epidural analgesia, the catheter is removed. This is not a painful procedure. In the case of cesarean section with epidural anesthesia, the catheter is not removed in the painful 48-hour period after the cesarean section. During this period, low doses of drugs that will relieve the mother are continued to be administered through the catheter. In this process, patient-controlled pain relief (PCA) can be applied. When the mother needs it, she can take the prescribed dose of painkillers by pressing the button of the device through the inserted catheter.

What are the advantages of epidural delivery?Noting that there are advantages to epidural birth, Dr. Tanrıkulu said, “Mothers who have had an epidural vaginal delivery recommend epidural delivery by stating that they both experience the pleasure of giving birth normally and that they do not have pain after delivery and that their energy is high. After birth, mothers can easily get out of bed and walk. Since they do not experience the fatigue and bruising of the pain during the birth process, the postpartum recovery process is quite fast. Immediately after birth, they can take care of and feed their babies by taking them in their arms. Since it will not stop bowel movements, gas extraction will not be prevented. Therefore, mothers do not experience gas bloating after delivery. When epidural analgesia is applied by experienced anesthesiologists at the right time and in the appropriate dose, it facilitates the opening of the cervix and accelerates the birth process. If it is not possible for the process to progress as a normal delivery after epidural analgesia is applied, the dose of the drug given can be increased and the delivery can be continued as a cesarean section with epidural anesthesia.