Pregnancy and Pain Relief during Child Birth

Most women are anxious at times to know if they are pregnant. Difficulties of confirming pregnancy vary greatly from one patient to another. Some women walk into a doctor’s office and announce that they are pregnant. The evidence to them is perfectly obvious. They may complain of nausea, inability to eat a certain food or lack of morning appetite, or sudden distaste for cigarettes. Their menstrual period is several weeks late. They may have noticed an increase in breast size with a feeling of heaviness, darkening of the area surrounding the nipples, increased frequency of urination, and a feeling of heaviness in the pelvic area. Some have marked salivation – excess of saliva.

A “package” of all the above-mentioned symptoms would surely indicate to an anxious woman that she is probably pregnant. But to the physician these signs are not truly diagnostic of pregnancy.
Pain Relief in Childbirth

If the patient is well prepared and understands the mechanism of labor, effective results can usually be obtained with minimal amounts of pain-relieving agents. The physician assesses the progress of labor by frequent examinations and gives the medication most appropriate to the exact stage of labor the patient is in.

Barbiturates may be given orally or rectally early in labor to produce sleepiness and relaxation. After labor has progressed to cervical dilation of about two inches, various morphine derivatives can be used effectively. Meperidine is a popular agent which reduces the pain threshold and makes the patient more comfortable. She may even fall asleep between contractions and wake up during the contractions.

If contractions become more violent, and the patient is somewhat apprehensive, scopolamine may be used. Scopolamine (called “twilight sleep” many years ago) is an amnesic or memory suppressing drug. Adequate amounts of it abolish the patient’s memory of the pain of labor and delivery.

After the cervix has opened to seven or eight centimeters in the second stage of labor it is usually inadvisable to give sedation. Contractions then are less painful and there is a great desire to push or “bear down.” The pushing sensation is similar to having a bowel movement. A large amount of sedation at this stage may make pushing less effective and slow the progress of labor.