Horizon Prime Hospital - Thane

“No Scar, No Pain, Only Gain – Now Give Birth To Your Child Painlessly” Says Dr Manali Shilotri, Leading Consultant Gynaecologist, Horizon Prime Hospital

Giving birth to your little one, is an ecstatic jubilant blessing that men cannot experience. Becoming a mother is a wonderful journey. Anticipating the arrival of a baby is an incredibly significant and cherished experience in a woman’s life. It encompasses a transformative journey, accompanied by distinctive physical and hormonal changes. Few things are more daunting for first-time moms than the prospect of childbirth. They wonder: Will my baby be OK? What will labor and delivery be like? How painful will it be, and can I handle it? Yes childbirth is painful. One of the most severe pain that a woman experiences in her lifetime, is the labor pain which leads to increase their desire to perform caesarean section. Fortunately, modern medicine has made remarkable advancements in reducing the discomfort of childbirth to a manageable level. One such ground-breaking technique is Epidural Analgesia, commonly known as painless normal delivery.

A painless normal delivery is a technique used to alleviate pain during childbirth. Its purpose is to provide relief by administering specific medications that reduce pain while still allowing effective pushing during delivery. To achieve this, a thin plastic tube called an epidural catheter is inserted through a needle, through which pain-relieving drugs are continuously delivered via an infusion pump.

The primary goal of an epidural is to manage and lessen the intensity of contractions, offering a more comfortable experience for the mother. It aims to bring the pain during labor to a tolerable level and often provides complete pain relief during the delivery of the baby. By carefully controlling the administration of medication, an epidural can significantly reduce discomfort and contribute to a more positive childbirth experience for the mother.

Dr Manali Shilotri, Leading Gynaecologist and Consultant Horizon Prime Hospital says “The very old saying that’s no gain without pain is now proving to be false. Thanks to the today’s modern technological advances that has been helping lot of pregnant women to give birth to their child without pain. It is natural for pregnant women to feel concerned, about the labor process and the inevitable pain that accompanies it. However, with revolutionary advancements, nowadays women get the option to opt for painless methods. Painless delivery is such a method that can help to reduce the pain during childbirth & enables women to enjoy it as well. Epidural is a type of anaesthesia, that is used to give relief from pain during labor. A large number of women prefer this procedure after knowing the benefits it provides”.

Dr Manali Shilotri further said “Epidural analgesia is an extremely effective method of pain reduction to manage labor pain. In many countries, it is a part of standard obstetric care. The epidural rate varies from 30% to 69% in Canada. In the US, 60% of women now opt for this technique. However, contrary to these statistics from developed countries, this method is still not widely popular in India”.

Dr Hrushikesh Vaidya, Medical Director and Chairman of Horizon Group of Hospitals  said “Every woman’s pain during labor is different and talking with your health care provider and physician anaesthesiologist can help you decide which pain management method will give you the best labor and delivery experience. Women may choose to use none, some or more than one pain management method depending on how labor progresses. Choosing one’s pain management method is a personal decision and you need to opt for those that work best for you.”

In case one opts for an epidural, a needle will be inserted in the lower back area along with a tiny tube- a catheter. Further, the needle is removed and the catheter is left behind for delivering medications through the tube. Epidural anaesthesia can be administered by doctors at any time of the labor. It needs the consultation with the physician and can be administered at the beginning or the middle or towards the end. Once you are in the state of active labor, then only the epidural can be administered at any time. It works by numbing the pelvic region and lower portion below it, while you remain in a state of consciousness”.

The timing of the epidural is a vital thing. Doctors may prescribe epidural soon after the contraction starts or later as the labor progresses. Epidural is mostly preferred by doctors once the would-be mother has active labor. Active labor is when the contraction is much stronger and closer as well.

Dr Manali Shilotri said “It may sound like a very painful procedure of having a needle and the insertion of the catheter at the lower back. Before the beginning of the procedure, doctors will give local anaesthesia to block the pain. You cannot feel the pain once the epidural insertion takes place into the area that is outside the spinal cord. Epidural will allow you to move and push but, all it depends is on the medication. As the labor advances, you can still feel the contractions but won’t be able to feel the pain”.

Advantages of Painless Normal Delivery

• Epidural painless delivery help a woman cope better with post-partum depression or exhaustion better.
• An epidural helps if your baby is not facing your backbone, and is not moving from the position in which it faces the belly button.
• The epidural injection will relax your vaginal muscles and provide space for the baby to descend.
• An epidural for normal delivery means there is a dip in the blood pressure of the mother. This is a benefit, because in natural labor, the mother has high BP. Also, there are risks of the pressure reaching dangerously high levels and ending in a stroke.
• An epidural makes it easy if the doctor has to carry out a forceps delivery or when an emergency C-section is needed.
• Studies show that epidurals prevent damage that would otherwise occur to the pelvic muscles during a normal delivery.

Disadvantages of Painless Normal Delivery

• Epidurals could cause backache, dizziness or shivering.
• A dip in the mother’s BP during labor can lead to a slowing down of the heart beat rate in the baby. If it doesn’t return to normalcy despite drugs/fluids, a Caesarean has to be carried out.
• There is also the risk of a mother-to-be experiencing severe headaches because of the fluid of the spine leaking.
• In certain cases, but very rare, there are chances of irretrievable damage to the nerves.
• An epidural is likely to cause numbness in the lower parts of the body after delivery. You may need help while walking because of the numb feeling.

Few Misconceptions women have about Painless Delivery

1. Choosing painless delivery, the chances of ending up needing a C-section are higher : Painless delivery might increase the chance of requiring instrumentation like forceps and vacuum to pull the baby out, but that too in a few cases. However, the claim that it increases the chances of a c-section is totally false.
2. Painless delivery can result in permanent back damage or paralysis in the mother: Back pain is common in women after delivering their child, only if they don’t do exercise and don’t take adequate calcium supplements during pregnancy and after delivery. But the assumption that the painless delivery can lead to paralysis has no evidence and scientific relevance. Also, cases of paralysis while delivering the child are very rare or not present.
3. Painless delivery can cause harm to the child : There is no scientific evidence that corroborates this saying. The mothers often tend to worry about their new-borns, but they need to be crystal clear that if they undergo painless delivery, it is as safe as any other option. No harm is caused to your infant with painless delivery.
4. Everyone can have painless delivery: Like any other treatment procedure, the type of delivery depends on the medical condition of the mother. The physicians assess your medical condition and previous history to determine your epidural ability. If the mother is carrying any underlying disease, the painless delivery may not be the right choice for her.
5. In painless delivery, I won’t be able to push the baby : The injected epidural tends to cause freezing in the body and ends up in numbness of the legs. However, you are able to push the baby comfortably irrespective of the weakness caused in the body.
6. Painless delivery can cause severe and unbearable headaches after delivery :Not every mother suffers from headaches due to the epidural used during pain less delivery. However, few women may feel a painful sensation in the head, which can be effectively treated by medication.

Common side effects of epidural are:

1. Itching
2. Nausea and vomiting
3. Fever
4. Soreness
5. Low blood pressure
6. Difficulty urinating

A few rare side effects of epidural are:

1. Breathing problems
2. Severe headache (1%)
3. Infection
4. Seizure
5. Nerve damage which is extremely rare which is about 1 in 4,000 to 1 in 200,000

The women who have the underlying conditions should avoid epidural. Such as:

1. Women who have certain bleeding disorders
2. If someone is having lower back surgeries
3. In case of neurological disorders

With the emerging technology and evolution in medical science, couples have started embracing the painless normal vaginal delivery methods and dropping the conventional techniques. Epidural analgesia can be a great option for mothers who want to manage their pain during labor and delivery. It is important to discuss this option with your healthcare provider and weigh the benefits and risks carefully. One has to remember that every pregnancy is different and what works for one mother may not work for another.