Health,  Life

Painless childbirth: The misunderstood “light of humanity”

  Do women have to live with pain when giving birth? Painless childbirth makes the baby stupid, and cesarean section is safer and more comfortable? Regarding painless childbirth, there are still many misunderstandings that need to be clarified…
  ”There is a ‘human light’ that has been used for nearly 200 years-painless childbirth, only 30% of Chinese mothers use it.” October 11, 2022 “World Pain Relief Day”, this topic rushed to the hot search. According to the “2022 World Pain Relief Day Survey Report” released by Physician Daily, Zhejiang Women and Children’s Foundation, and Babycare: As many as 36% of the respondents “don’t know or have only heard of” painless childbirth.
  In my country, 82% of hospitals support painless childbirth, but only 54% of families actually adopt it, and the overall popularity rate of painless childbirth is only 30%. So, what is the reason that prevents nearly 70% of women from enjoying the “light of humanity”?
  I heard that giving birth must be painful
  . “There is no department that concentrates such a large-scale pain like the delivery room.” Zhang Qi, an anesthesiologist at a obstetrics and gynecology hospital in Beijing, described it in the “Painless Delivery” post bar, “Every time When I go to work, I can hear shouts one after another when I go to the door. There are more than ten or twenty expectant mothers and women on the delivery bed shouting inside. Whenever this happens, I really want to give them all painless, so that They rest quietly.” Zhang Qi said that not all pregnant women are willing to accept painless childbirth, some insist on their own opinions no matter how the doctor guides them, and some are so painful that they decide to have painless childbirth temporarily. I will also blame myself and regret.
  Is childbirth pain a fate that women must bear? For many people, it is. “Why don’t you just have a baby!” “All women can afford to suffer, why can’t you?” These voices make many women have to agree with and accept the pain of childbirth, and some women refuse to bear children because of fear of pain.
  Having a baby is so painful. The parturient Zhang Qi had been in contact with for the longest time was in pain for 4 full days before meeting the conditions for painless delivery. At the beginning, she resolutely refused to do painless childbirth, “my mother, mother-in-law and sister all came here like this.” Facing her in severe pain, her mother-in-law and mother told her to “bear it a little longer and she will be fine after giving birth” while wiping away tears. In the end, she was in pain for 4 days, and before the baby landed, she yelled loudly in the delivery room: “I want to be painless, and no one will stop me!” Because of the pain, her facial expression was grim, her body curled up in pain, thick The hospital gown was soaked with sweat. Seeing Zhang Qi, she cried loudly: “You are finally here, save me!”
  The clothes and skin of this 25-year-old young mother were mixed with blood, vomit and secretions. It hurt for 4 days…and 10 minutes after the painless anesthesia injection, she fell into a deep sleep, and never cried again until the baby was born. She told Zhang Qi: “The wisest decision I have made in the past 25 years is to accept painless childbirth.” However, because she insisted on painless childbirth, her mother-in-law did not come to the hospital to pick her up on the day she was discharged, and asked her son to bring a message: “When the time comes, if the child If there is any problem, blame yourself.”
  This woman’s experience is not unique. As an anesthesiologist, Zhang Qi heard the most ridiculous sentence: “How can you give birth without pain? Lying there comfortably, how can you have the strength to give birth?”
  How painful is childbirth? Like all the ribs of the whole body are broken, like a truck rolling back and forth on the stomach, like being thrown into a fire to be smoked… This is the feeling of mothers who give birth naturally. Most men can only endure about level 6 of the 10 levels of labor pain that women suffer. In August 2017, the tragedy of Ma Rongrong, a parturient woman in Yulin City, Shaanxi Province, jumped off the building due to unbearable labor pains, which hurt the hearts of countless people. Some people questioned why she did not accept painless childbirth, and some people were afraid of childbirth because of this, and did not want to risk their lives.
  In fact, even professional obstetrics and gynecology medical staff once believed that labor pains must be borne by women. A doctor at the Obstetrics and Gynecology Hospital Affiliated to Fudan University gave birth to her first child in 2014 and became pregnant again after 7 years. Although she is a doctor of obstetrics and gynecology, she feels that she has experienced natural delivery, and the second child should be faster and pain-free. When the anesthesiologist Lu Yaojun asked “do you need help from the anesthesiology department”, she refused decisively: “I’m not afraid of pain!”
  ”I was on night shift that day, and when I was administering anesthesia to a woman for a painless delivery, I heard screams coming from the ward next door.” Lu Yaojun heard the sound and walked over, and it was the woman who said, ” Not afraid of pain” doctor. When asked if she needed help, her eyes lit up and she said, “The stupidest thing I did was to refuse the anesthesiology department. Can you help me? It hurts too much!” Lu Yaojun quickly gave her anesthesia. After 10 minutes, the labor pain was relieved obviously, until the fetal head came out in the second stage of labor, the whole labor process was very comfortable. “Painless childbirth is really the ‘light of mankind’!” Since then, this obstetrician has strongly recommended painless childbirth to doctors, nurses and friends around him.   The reason is simple, painless
childbirth is so delicious, women really don’t need to endure the pain of childbirth.
learn. “From the revolutionary delivery room to the calm communication delivery room, painless delivery is really the ‘light of humanity’!” This is the common aspiration of almost all obstetrics and gynecology medical staff.
  In 1847, the British Simpson used ether and chloroform for maternal analgesia. Queen Victoria gave birth to Prince Leopold in 1853 and Princess Bradleys two years later. In 1910, China fully introduced painless delivery technology and began to use anesthetics in obstetrics. Spinal anesthesia, which is widely used today, was promoted in 1930 and popularized in 1940.
  my country’s first painless childbirth operation was performed by Zhang Guangbo, an obstetrician and gynecologist at Peking University First Hospital in 1963. In the following year, she performed painless childbirth operations for 67 puerperas. In 2000, painless childbirth began to be promoted, and the technical means have been quite mature. However, until 2018 when the National Health and Medical Commission issued a document to encourage pilot painless delivery, its utilization rate was less than 10%.
  During this period, in pursuit of painlessness, some mothers would rather give up natural delivery and choose cesarean section, because in the traditional sense, cesarean section is safer for the fetus. “Painless childbirth is not good for babies” and “anesthetics affect children’s intelligence”. Many misunderstandings make women and their families always have doubts about painless childbirth. Therefore, although anesthesiologists in various hospitals are popularizing science, the anesthesia dose used for painless delivery is only 1/10 of that of cesarean section, and will not affect the mother and fetus. Although the National Health and Medical Commission listed 913 hospitals in 2018 It is a pilot project of painless delivery, and the current prevalence rate of painless delivery in my country is still only 30%.
  How safe is painless childbirth with a history of nearly 200 years?
  Painless labor is a drug-induced analgesic method in labor analgesia. The most common and widely recognized method is spinal anesthesia. Doctors insert a long needle into the lumbar spine, place a flexible tube in a specific location—either the epidural space or the subarachnoid space—and then withdraw it. During the progress of labor, the mother can self-administer the drug by pressing the drug pump on the catheter.
  The anesthetic acts directly on the dura mater, temporarily blocking this pathway of nerve signal transmission. The anesthetic will not enter the blood circulation, because the mother needs to work hard with the uterine contraction to complete the delivery, so it will not be completely anesthetized, but will retain a certain amount of pain. Therefore, the amount of anesthetic used is only 1/5 to 1/10 of that of cesarean section, which mainly plays an analgesic role. With only the possible side effects of anesthesia, painless childbirth is much safer than cesarean section.

  ”Painless childbirth belongs to local anesthesia, which only acts on the mother’s spinal canal, does not pass through the placenta, and has no effect on the intelligence of the fetus.” Leader of the National Health Commission’s Labor Analgesia Pilot Expert Working Group, Anesthesiologist at the First Medical Center of the PLA General Hospital Professor Comey Weidong emphasized this common sense more than once.
  Many women worry that neuraxial labor analgesia will lead to postpartum headache, low back pain, decreased breast milk quality, lethargy, and dystocia cesarean delivery rate. In fact, no studies to date have demonstrated that neuraxial labor analgesia causes these complications.
  Of course, any drug or operation has its side effects, and painless childbirth is no exception. The most common ones are hypotension, headache, local anesthetic poisoning, total spinal anesthesia, ineffective anesthesia, and other conditions such as chills, dizziness, nausea, vomiting, itchy skin, and urinary retention.
  But the occurrence rate of the above situation is very low. Lu Yaojun said that as long as the anesthesiologist closely observes and monitors vital signs such as blood pressure and breathing, these risks can basically be discovered and dealt with in time.
  Maternal love does not need to endure pain
  ”The pain of childbirth should be paid attention to, not just praised.” Dai Nianwen, producer of the documentary “Birth Gate”, said. As a recorder and long-term observer of fertility issues, he focused his camera on pregnant women seven years ago and described the pain of childbirth they experienced. “Birth Gate” received widespread attention once it was broadcast, and it is still popular today. In addition to admiring the greatness and fearlessness of mothers, there are also many people who regret that they did not choose painless childbirth.
  ”The fertility problem is not an individual problem, but a group problem. There are many problems related to fertility that need to be solved, and we can start by solving the pain of childbirth.” Dai Nianwen regretted that his wife did not choose to be painless when giving birth. The wives feel that the pain of childbirth is something a woman must bear. Although the doctor suggested painless childbirth, they refused without even thinking about it. Now that her daughter is far from the age to get married and start a family, Dai Nianwen has already agreed with her that if she gets married and has children in the future, as long as the comprehensive assessment conditions permit, she must receive a painless injection as soon as possible.
  Of course, not all women are suitable for painless childbirth. Lu Yaojun said that women with blood coagulation disorders, severe infection or injury at the puncture site, severe spinal deformity, clinical intracranial hypertension, or premature babies who must undergo emergency cesarean section are not suitable for painless delivery. “There are also a very small number of women who are unable to cooperate with the doctor for anesthesia because of the pain. However, I have only encountered two cases in the past 10 years as an anesthesiologist.” Lu Yaojun said that each woman’s situation is different, and the obstetrics department of the hospital will make a decision based on its own situation. Accurate assessment.
  As the first batch of pilot hospitals for painless childbirth in my country, Lu Yaojun said that the medical staff of the Obstetrics and Gynecology Hospital Affiliated to Fudan University will recommend painless childbirth to every eligible mother. Most people will accept it, and some people firmly refuse at the beginning, and when the pregnant woman’s cervix dilates and the pain is unbearable, she desperately asks for pain-free surgery, “the pain has been in vain for so long”.
  According to Xinhua News Agency, in 2011, China’s cesarean section rate was as high as 46%, which was more than three times the “warning line” of 15% set by the World Health Organization (WHO). The problem of abuse is serious. The reason why many people choose cesarean section is also because they are afraid of pain and worry that the anesthetics during painless delivery will affect the child’s intelligence. But in fact, the risks and harms of cesarean section are far greater than painless childbirth.
  Caesarean section also requires anesthesia, and the dose is higher. In addition, you have to face postoperative pain and healing, urinary retention and other adverse reactions. Among them, the biggest risk is the scarred uterus. If the fetus implants on the scar during another delivery, it will cause fatal dangers such as uterine rupture. The promotion of painless childbirth has greatly reduced the number of cesarean sections, because the production process is more comfortable, no knife is needed, and the postpartum body recovers faster.
  In addition to traditional concepts, there are not a few people who worry that the money is not worth the money. Isn’t painless childbirth just a shot of anesthesia? The cost is not low and has to be paid by oneself, which is not cost-effective compared with the cesarean section that can be covered by medical insurance. According to Lu Yaojun, painless childbirth is not as simple as an injection of anesthesia, from midwife consultation when the mother enters the delivery room, to prenatal anesthesia evaluation outpatient pros and cons analysis, to the whole labor process of anesthesia injection and increased dose according to the actual situation A complete set of monitoring and management costs about 2,000 yuan, and in hospitals in Beijing and Shenzhen that perform painless childbirth operations, the cost is mostly less than 3,000 yuan. Compared with the 10-level pain that the mother has to endure if she does not accept the pain, and the postpartum depression that may be caused by the pain of childbirth (studies have found that a large part of postpartum depression is related to the pain of childbirth), this money is actually spent. value.
  In August 2022, 17 departments including the National Health and Medical Commission issued the “Guiding Opinions on Further Improving and Implementing Active Fertility Support Measures”, which specifically proposed to expand the pilot program of painless childbirth and improve the level of painless childbirth. While strengthening policy guarantees, Zhejiang, Jiangxi, Shanghai, Guizhou and other places have successively included painless childbirth in the scope of medical insurance.
  Yao Shanglong, the third chairman of the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and the third president of the Anesthesiology Branch of the Chinese Medical Doctor Association, said: “There is no need to endure labor pain, and it will not bring any meaningful value to childbirth.”
  National Anesthesiologist Huang Yuguang, director of the Quality Control Center and chairman of the Anesthesiology Branch of the Chinese Medical Association, said: “Anaesthesia is a discipline that emerged as the time required for human beings to overcome pain. We call on all parties to work together to create a Chinese solution for painless childbirth, so that more women will have more comfortable and more comfortable childbirth. Dignified.”
  Of course, whether to accept painless childbirth is completely voluntary by the mother and her family. However, it should be the basic cognition of modern women to abandon the traditional concepts of “giving birth will definitely be painful” and “doing painless will affect the fetus”, and not to make extreme choices or even refuse to have children because of the blind fear of pain.
  At any time, women can make free choices for reproduction, which is the real “light of humanity”.

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