Childbirth is the greatest dream for many women, and it can also be a nightmare for others due to the fear of pain. Painless childbirth is a dream for all women. Some even give up on being biological mothers because they fear the famous labor pains of vaginal delivery and also those of a cesarean, not to mention the fear of anesthesia. But fortunately, anesthesia methods have become increasingly modern, allowing vaginal delivery to be more and more painless. Naturally, this makes many mothers choose this option, especially since the side effects have decreased compared to the past.

In most cases, for a painless delivery, what distinguishes the anesthetics is their composition. They can be used for all types of childbirth and allow the mother to stay alert and awake to see her baby as soon as they are born. Both are used to block pain sensation only from the waist down. Doctors inject the anesthesia between the 3rd and 4th lumbar vertebrae using a very thin, almost imperceptible needle. Most needles are as thin as a hair! After insertion, the doctor advances the needle until reaching the epidural space to inject the medication. It does not reach the nerves nor the vertebra itself. The blockers prevent pain spasms from reaching the nerves and the electrical impulses that notify the brain about pain. In cases of vaginal delivery, a woman can choose whether or not to receive anesthesia—she just needs to express her wish to her doctor.

What Is the Best Option for a Painless Childbirth?

For different types of childbirth—vaginal, cesarean, humanized, or involving procedures—the types of anesthesia are:

Epidural Anesthesia: This anesthesia is used for all types of childbirth involving hospital intervention. Usually, the doctor administers the epidural so the woman can have a painless delivery or tolerate contraction pain, allowing her to know the exact moment to push to expel the fetus.

The amount of anesthetic can determine whether or not the woman remains able to move. If a small amount is injected, the woman may still move her legs; with a larger amount, she will become immobile from the waist down, feeling heaviness. It is generally well tolerated by women and its effects wear off quickly—about an hour after the catheter is removed, the mother is usually able to feel her legs again. It also results in few side effects after delivery.

Cesarean sections performed with this type of anesthesia require higher doses. It is also with this type of medication that many women report feeling the movements made by doctors during delivery, because although it removes pain, it does not eliminate all sensation. The drawback of this type of anesthesia is the time it takes to take effect: it may take 10 to 20 minutes to work as expected.

Spinal Anesthesia: Spinal, or spinal block, is the most commonly used anesthesia for procedures below the waist, such as cesarean delivery. It is a type of nerve blocker, as well as blocking the spinal cord that transmits pain signals to the brain. It is applied in the same way as an epidural, but with the difference that spinal anesthesia is a single dose and cannot be increased except by a second injection; it is also injected a bit deeper than the epidural and its effects begin immediately after application.

The effect of the spinal anesthesia is usually a warm sensation flowing down the legs and a feeling of heaviness. Spinal anesthesia truly provides a painless delivery, as the woman feels absolutely nothing from the waist down—not even the movements made by the doctors.

The disadvantages of spinal anesthesia are the side effects it may cause and also the possibility that it may not work on the first attempt. Many women may experience shivering and hives after the anesthesia wears off, which happens about 1 hour and 30 minutes after the peak of pain blockage. It is also recommended that the woman remain lying down for a few hours after the anesthetic is given to avoid post-spinal headache, which is expected to be eliminated with advances in the formulation and application technique.

Some procedures require combined anesthesia. This is known as double block and uses both types of anesthesia. Spinal anesthesia is administered while the epidural is gradually released during the procedure at the same site where the spinal was administered. In more extreme cases when neither anesthesia is suitable, doctors may opt for painless childbirth via general anesthesia. If a cesarean section must be performed, the mother will not see the baby’s birth but this can be safer for both mother and child.

For a painless vaginal birth, many women choose anesthesia for greater comfort during the pushing stage, while others prefer to face the pain head-on with courage. Remember that anesthesia does not harm the baby in any way.

In case of any doubts, it is advisable for the mother to consult an anesthesiologist to clear up all her questions and to identify any real risks in her specific case, although analgesia is safe in the vast majority of situations.

See also: Spinal Anesthesia

Photo: Andres Rueda