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Numb the Body for Crowning

What makes a pregnant woman afraid of delivery? The main reason is pain. Every pregnant lady experiences panic attacks thinking about the process and pain. This pain would be controlled by anaesthesia.


What and how does anaesthesia work?


 


Normal Delivery-


Normally, a baby would be 2.5 kg to 3.5 kg in India. So, that 2.5 to 3.5 kg baby has to come out through the mother’s pelvic bone. A pelvic bone is nothing but the hip bone. Imagining a big baby coming out of that pelvic path would be terrifying and unbelievable.


Gynaecologist doctors follow some steps to bring the baby out of that pelvic path. It is called "episiotomy".


A cut (incision) between the vaginal opening and the anus is known as an episiotomy. This area is called the perineum. This procedure is done to make the vaginal opening larger for childbirth.


When normal delivery is attempted, the vaginal path would be a narrow passage and we would have to widen it to take the baby out.


The process of delivering is called "crowning." When the head of the baby is about to come out and in the perfect lower down position, a dose of local anaesthesia would be injected into the skin, which is the outer layer of the vaginal passage, which is called the labia.


 


As soon as the anaesthesia was injected, a controlled cut would be given using sterile scissors. They cut the skin where the anaesthesia was injected. This cut can be done in two different areas.



  • Median cut – Earlier times, they cut at the centre, which is called a median cut.



  • Mediolateral – which would be cut at the sides. It may be right or left.


The median cut was mostly avoided by doctors since the excretory passage is very close to the centre. It may affect the motion path. So the median cut is avoided nowadays.


The most preferred was mediolateral. It was cut during the intense pain. This cut would help the baby come out easily.


If it was not cut, when the baby is born, the labia may tear erratically, resulting in severe bleeding. The cut would be stitched by the doctors as soon as the delivery process was over. This is a process for normal labour.


When someone is in normal pain and needs to be delivered from the pain, it may be for normal or caesarean. Both processes need anaesthesia to control the pain.



  • Epidural Anaesthesia – Normal



  • Spinal Anaesthesia – Cesarean


 


Epidural anaesthesia-


It would be given to both normal and cesarean patients.


The word "epidural" must be split into two to get into the depths of the body.



  • Epi – So near (Close enough)



  • Dura – Outer sheet (Cover of the spinal card)


In the spinal cord, there are many bones attached together, which is called vertebra. In between these bones, a spinal canal would pass through. This Epidural anaesthesia would be injected into this area. This would not directly touch the nerves, but would be given outside the sheet and relieves the pain. It means, the anaesthesia would be close enough to the sheet but not get inside the sheet.


This would be given two or three times depending upon the pain. As soon as they inject they will remove the outer sheet of the needle and it will have only the guidewire and the epidural. Then the dosage would be given through that wire.


It numbs the lower part of the hip. Its process would be slow. According to the pain, the doctor gives the dosage 2 to 3 times within 15-20 minutes. So that they have the pressure. Then they would push and deliver the baby, naturally or normally. It does not have any major or minor side effects on the baby or on the mother. It would just numb the mother’s lower hip area during the delivery time alone. It also has an advantage that relieves the pain while stitching the labia cut.


 


Spinal Anaesthesia-


So, the word "spinal" itself describes what it would be regarding the spinal cord. In this process, the anaesthesia would be injected directly into the spinal cord.


Spinal anaesthesia would be given to pregnant women alone. This spinal anaesthesia acts very fast. This would be injected only once. The sensation of numbness in the lower body happens very quickly. The dosage would be given according to the pain, and it takes 30–40 minutes for a treatment.


When an epidural was already given, this spinal anaesthesia would also be given along with that to have complete pain relief for performing the surgery.


In-short:


























Epidural Numbness



Spinal Numbness



Active Phase of labour



 Direct to spinal canal



Outer part of the spinal canal



Acts very quickly



Requires top-up dose



One-shot injection



Takes little time to act.



Instant numbness



 


Pain hovers-


Anaesthesia would be injected by a woman during her pregnancy time to get delivery from that pain. But the agony she endures after that delivery is perplexing. It gives life-long back pain. Normal and caesarean deliveries would not be affected by the woman's workouts. It depends on the baby’s position and movements.


The process itself panics a woman into not getting into the labour ward. But the woman takes heart and brings a new life into the world. It reforms her physical body. She tries to split open her body in order to bring another life into the world.


She numbs herself and crowns the baby.


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