CHILDBIRTH & ANESTHESIA
Printer FriendlyTHE ANESTHESIOLOGIST'S ROLE IN LABOR AND DELIVERY
The anesthesiologist's goals, when consulted to
participate in the care of women in labor, are very much the same as those
of her Obstetrical Care Provider:
• To facilitate comfort during a natural but typically
painful process
• To do so in a way that minimizes risk to both the mother and her
soon-to-be-born baby
The American College of Obstetricians and Gynecologists
has suggested that: "Labor results in severe pain for many women. There
is no other circumstance where it is considered acceptable for a person to
experience severe pain, amenable to safe intervention, while under a
physician's care." Anesthesiologists endorse this belief and, as
specialists in the management of acute pain, view labor pain relief as a
professional duty and responsibility.
There are many opinions about how to best facilitate comfort in a laboring
woman. However, it is the woman, herself, who decides which method is best
for her. Usually a pregnant woman will already have a plan for coping with
pain before labor begins, and an informed approach is to be encouraged. It
is very clear, however, that no two labors are identical, and that the
subjective experience of pain can be difficult to anticipate. For example, a
woman may find labor pain to exceed her expectations. Sometimes this woman
may have planned a "natural birth" (without any medical intervention for
pain) and, unfortunately, may feel that it is somehow a "failure" should she
decide to use one of the medical alternatives for alleviating discomfort and
anxiety.
Less commonly, labor pain is experienced as less than expected so that a
woman might decide that an original plan for medical pain intervention is
not needed or wanted. Accordingly, anesthesiologists advise flexibility in
the pain management aspect of labor plans.
Modern anesthesiology and obstetrics have numerous effective methods that
allow a woman to have choices regarding labor pain management. These choices
include:
• Breathing exercises and relaxation techniques
• Intravenous pain medications
• Local nerve or field blocks
• Regional techniques (epidural or spinal anesthesia)
The anesthesiologist can assist a woman and her
obstetrical care provider in making individualized choices about pain
management. More importantly, the anesthesiologist has the skills, working
as a team with obstetrical care providers, to assure both safety and comfort
for mother and baby.