3.  Labor Pain : Worst
imaginable pain
 No other situation where
severe pain is acceptable
 15th Century – Midwives
offered pain relief burned
(wrong to avoid the pain of
divine punishment)
 Biologic process subject to
study and control by new
methods of science.
 Queen Elizabeth eighth
child
 Last 100 years : Most
Effective & safe(ACOG
recommended)

4.  Uterus contracts & relaxes
to push baby down. These
contractions like a vigorous
exercise are responsible for
pain.
 Pain impulses travel from
the uterus to the brain via
nerves in the backbone.
 Initially mild, slowly
increases in frequency and
severity. More in anxious
and in primi.
 Each women’s labour is
unique.

5.  Pain impulses are blocked with in the
back bone and they do not reach the
brain.

6.  Epidural techniques block the pain
produced by uterine contractions. They
do not reduce intensity & frequency of
contractions. Thus, it does not have bad
effect on progress of labour, actually it
fasten the progress.

7.  Systemic Medication

8.  Minimize pain but not labour and safe to
both baby and mother.

9.  AROMATHERAPY
 HYPNOTHERAPY
 LAMAZE TECHNIQUE
 ACUPUNCTURE
 TENS
 BATHING
 TOUCH & MASSAGE

11.  EPIDURAL  SPINAL

12.  Combined Spinal
Epidural

17.  ACOG (American College Of
Gynecologists) Recommendations:
Maternal Request is sufficient indication

18.  Beneficial : Increases blood flow
 Newborn outcome better

19.  Walking or Sitting more upright
Speeds up the progress of labor

20. Active Labor :
•Avoid Solid food
•Clear fluid (Water, Fruit juices
without pulp, cold drinks, clear tea,
black coffee.) 1glass/hr

21. Excellent worldwide safety record. As with
any procedure, however, some patients
may experience some minor side effects
like shivering; decreased blood pressure;
mild itching in labor; headache;
persistent pain in some areas, etc. Other
complications are very rare like local
anesthetic reaction(inform if H/O allergy)

22. Apart from pain relief,
 Increases blood supply to baby and
improves its well-being . Especially where
blood supply to baby is compromised e.g.
High BP, Growth restricted babies etc.
 Shorten duration of labour.
 Studies have also shown that the
caesarean delivery rate is reduced.
 If a patient requires emergency caesarean
section, anaesthesia given through the
same catheter without additional pricks.

23.  Does Epidural increases the chances of Cesarean
Section ?
 No
 Does Epidural affect Breast feeding ?
 No
 Does Epidural cause back pain ?
 No. The reason for backache after delivery :
-laxity of ligaments & abdominal muscles,
-change in the curvature of back,
-lack of calcium in diet / supplement.

24.  Scared of needles ?
 Before epidural needle, numbing medicine
with tiny , thin needle, less painful than labor
pain. Then you only feel pressure.
 Will I able to push?
 Yes. It make pushing more comfortable.
 Will I be able to urinate
 Every hour pass urine, without urge.

25.  Do I have to stay in bed?
 Not necessarily.
 What will I feel?
 Significant pain relief will occur, may aware of
pressure of contractions. May temporary
numbness, heaviness in legs.
 How long will block last ?
 Till delivery with additional doses. After delivery,
catheter will be removed and, within a few
hours, sensations will return to normal.

26.  What if I plan for delivery without Epidural ?
 By all means you can go ahead. At any
time if you feel that it is too much to bear
the pain and change your mind, we will be
happy to help you. Changing your mind
should not be considered as failure.
 Situations where Epidural have an
advantage?
 High BP, Heart diseases, Lung diseases etc.

27.  http://www.aoaindia.com/patient
Information.html

28. ENJOY YOUR CHILDBIRTH