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(Replaced content with '=='''No need for pain control. Child birth is natural. If you can't handle it don't have one. SORRY DOCTOR WITH THE DEGREE.'''== Category:Childbirth Category:Pain')
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=='''No need for pain control. Child birth is natural. If you can't handle it don't have one. SORRY DOCTOR WITH THE DEGREE.'''==
 
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[[Category:Childbirth]]
 
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===Experience of pain in childbirth===
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===Pain control===
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;Non pharmaceutical
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Some women prefer to avoid [[analgesic]] medication during childbirth. They still can try to alleviate labor pain using psychological preparation, education, massage, hypnosis, or water therapy in a tub or shower. Some women like to have someone to support them during labor and birth, such as the father of the baby, the woman's mother, a sister, a close friend, a partner or a [[doula]]. Some women deliver in a squatting or crawling position in order to more effectively push during the second stage and so that [[gravity]] can aid the descent of the baby through the birth canal.
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The human body also has a chemical response to pain, by releasing [[endorphin]]s. Endorphins are present before, during, and immediately after childbirth.<ref name="brinsmead">{{cite journal
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|journal=Aust N Z J Obstet Gynaecol
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|year=1985
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|month=August
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|volume=25
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|issue=3
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|pages=194–7
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|author=Brinsmead M
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|coauthors=Smith R, Singh B, Lewin T, Owens P
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|title=Peripartum concentrations of beta endorphin and cortisol and maternal mood states
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|pmid=2935137 | doi = 10.1111/j.1479-828X.1985.tb00642.x
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}}</ref> Some [[homebirth]] advocates believe that this hormone can induce feelings of pleasure and euphoria during childbirth,<ref name="buckley">[http://www.kindredmedia.com.au/library_page1/giving_birth_the_endocrinology_of_ecstacy_/75/1 Kindredmedia.com.au], Giving Birth: The Endocrinology of Ecstacy</ref> reducing the risk of [[Postpartum depression|maternal depression]] some weeks later.<ref name="brinsmead" />
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[[Water birth]] is an option chosen by some women for pain relief during labor and childbirth, and some studies have shown waterbirth in an uncomplicated pregnancy to reduce the need for analgesia, without evidence of increased risk to mother or newborn.<ref>{{cite journal |author=Eberhard J, Stein S, Geissbuehler V |title=Experience of pain and analgesia with water and land births |journal=Journal of psychosomatic obstetrics and gynecology |volume=26 |issue=2 |pages=127–33 |year=2005 |pmid=16050538 |doi=10.1080/01443610400023080}}</ref> Hot water tubs are available in many hospitals and birthing centres.
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[[Meditation]] and mind medicine techniques are also used for pain control during labour and delivery. These techniques are used in conjunction with progressive muscle relaxation and many other forms of relaxation for the mind and body to aid in pain control for women during childbirth. One such technique is the use of [[hypnosis in childbirth]].
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A new mode of analgesia is sterile water injection placed just underneath the skin in the most painful spots during labor. A control trial in Iran of 0.5mL injections was conducted with normal saline which revealed a statistical superiority with water over saline.<ref name="Shohreh Bahasadri">{{cite journal|author=Shohreh BAHASADR|co-authors=Sara AHMADI-ABHARI, Mojghan DEHGHANI-NIK, Gholam Reza HABIBI|title=Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 46 2006 Issue 2, Pages 102 - 106}}</ref>
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;Pharmaceutical
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Different measures for pain control have varying degrees of success and side effects to the woman and her baby. In some countries of [[Europe]], doctors commonly prescribe inhaled [[nitrous oxide]] gas for pain control, especially as 50% nitrous oxide, 50% oxygen, known as [[Entonox]]; in the [[United Kingdom|UK]], midwives may use this gas without a doctor's prescription. [[Pethidine]] (with or without [[promethazine]]) may be used early in labour, as well as other [[opioid]]s such as [[fentanyl]], but if given too close to birth there is a risk of respiratory depression in the infant.
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Popular medical pain control in hospitals include the regional anesthetics [[epidural]] blocks, and [[spinal anaesthesia]]. Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, more operative intervention (particularly instrument delivery), and increases in cost.<ref>{{cite journal |author=Thorp JA, Breedlove G |title=Epidural analgesia in labour: an evaluation of risks and benefits |journal=Birth (Berkeley, Calif.) |volume=23 |issue=2 |pages=63–83 |year=1996 |pmid=8826170 |doi=|quote=Epidural analgesia is a safe and effective method of relieving pain in labour, but is associated with longer labour, more operative intervention, and increases in cost. It must remain an option; however, caregivers and consumers should be aware of associated risks. Women should be counseled about these risks and other pain-relieving options before the duress of labour.}}</ref> One study found that the women receiving epidural analgesia had more fear before the administering of the epidural than those who did not receive it, but that they did not necessarily have more pain.<ref>[http://www.informaworld.com/smpp/content~content=a723866678~db=all Informaworld.com] Siw Alehagen, Barbro Wijma, Ulf Lundberg, Klaas Wijma, "Fear, pain and stress hormones during childbirth", ''Journal of Psychosomatic Obstetrics & Gynecology'', Vol. 26, No. 3, pp. 153-165, (Sep. 2005)</ref>
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Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus.<ref>[http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-199508000-00010.htm;jsessionid=HGBLnWDrGwwXTpznK3pv4qFtFsLFh3k9pLR3MpfZXnh2w1ZFY1TB!-667243907!181195629!8091!-1 Anesthesiology.org] Loftus, John R; Hill, Harlan; Cohen, Sheila E. "Placental Transfer and Neonatal Effects of Epidural Sufentanil and Fentanyl Administered with Bupivacaine during Labour" '''Anesthesiology''', Vol. 83, No. 2, pp 300-308 (August 1995)</ref> Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an immediate effect on neonatal status as determined by Apgar scores.<ref name="Anim-Somuah">{{cite journal|author=Anim-Somuah M|co-authors=Smyth R, Howell C|title=Epidural versus non-epidural or no analgesia in labour.|pmid=16235275|journal=Cochrane Database Syst Rev.|date= October 19, 2005 |volume=4|doi=10.1002/14651858.CD000331.pub2}}</ref>
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[[Category:Birth]]
 
[[Category:Pain]]
 
[[Category:Pain]]

Latest revision as of 23:47, 11 May 2010

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Experience of pain in childbirth

Pain control

Non pharmaceutical

Some women prefer to avoid analgesic medication during childbirth. They still can try to alleviate labor pain using psychological preparation, education, massage, hypnosis, or water therapy in a tub or shower. Some women like to have someone to support them during labor and birth, such as the father of the baby, the woman's mother, a sister, a close friend, a partner or a doula. Some women deliver in a squatting or crawling position in order to more effectively push during the second stage and so that gravity can aid the descent of the baby through the birth canal.

The human body also has a chemical response to pain, by releasing endorphins. Endorphins are present before, during, and immediately after childbirth.[1] Some homebirth advocates believe that this hormone can induce feelings of pleasure and euphoria during childbirth,[2] reducing the risk of maternal depression some weeks later.[1]

Water birth is an option chosen by some women for pain relief during labor and childbirth, and some studies have shown waterbirth in an uncomplicated pregnancy to reduce the need for analgesia, without evidence of increased risk to mother or newborn.[3] Hot water tubs are available in many hospitals and birthing centres.

Meditation and mind medicine techniques are also used for pain control during labour and delivery. These techniques are used in conjunction with progressive muscle relaxation and many other forms of relaxation for the mind and body to aid in pain control for women during childbirth. One such technique is the use of hypnosis in childbirth.

A new mode of analgesia is sterile water injection placed just underneath the skin in the most painful spots during labor. A control trial in Iran of 0.5mL injections was conducted with normal saline which revealed a statistical superiority with water over saline.[4]

Pharmaceutical

Different measures for pain control have varying degrees of success and side effects to the woman and her baby. In some countries of Europe, doctors commonly prescribe inhaled nitrous oxide gas for pain control, especially as 50% nitrous oxide, 50% oxygen, known as Entonox; in the UK, midwives may use this gas without a doctor's prescription. Pethidine (with or without promethazine) may be used early in labour, as well as other opioids such as fentanyl, but if given too close to birth there is a risk of respiratory depression in the infant.

Popular medical pain control in hospitals include the regional anesthetics epidural blocks, and spinal anaesthesia. Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, more operative intervention (particularly instrument delivery), and increases in cost.[5] One study found that the women receiving epidural analgesia had more fear before the administering of the epidural than those who did not receive it, but that they did not necessarily have more pain.[6] Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus.[7] Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an immediate effect on neonatal status as determined by Apgar scores.[8]

  1. 1.0 1.1 Brinsmead M, Smith R, Singh B, Lewin T, Owens P (August 1985). Peripartum concentrations of beta endorphin and cortisol and maternal mood states. Aust N Z J Obstet Gynaecol 25 (3): 194–7.
  2. Kindredmedia.com.au, Giving Birth: The Endocrinology of Ecstacy
  3. Eberhard J, Stein S, Geissbuehler V (2005). Experience of pain and analgesia with water and land births. Journal of psychosomatic obstetrics and gynecology 26 (2): 127–33.
  4. Shohreh BAHASADR. Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 46 2006 Issue 2, Pages 102 - 106.
  5. Thorp JA, Breedlove G (1996). Epidural analgesia in labour: an evaluation of risks and benefits. Birth (Berkeley, Calif.) 23 (2): 63–83.
  6. Informaworld.com Siw Alehagen, Barbro Wijma, Ulf Lundberg, Klaas Wijma, "Fear, pain and stress hormones during childbirth", Journal of Psychosomatic Obstetrics & Gynecology, Vol. 26, No. 3, pp. 153-165, (Sep. 2005)
  7. Anesthesiology.org Loftus, John R; Hill, Harlan; Cohen, Sheila E. "Placental Transfer and Neonatal Effects of Epidural Sufentanil and Fentanyl Administered with Bupivacaine during Labour" Anesthesiology, Vol. 83, No. 2, pp 300-308 (August 1995)
  8. Anim-Somuah M (October 19, 2005). Epidural versus non-epidural or no analgesia in labour.. Cochrane Database Syst Rev. 4.