Natural versus Epidural

The World Health Organization (WHO) published recommendations on Intrapartum Care for positive childbirth experience in 2016. The guideline recognizes a ‘positive childbirth experience’ as a significant endpoint for all women undergoing labor. Pain control during labor and delivery is definitely an integral part of this beautiful experience. 

Not all women experience the same level of pain during childbirth. This variability is attributed to a number of factors—primarily nulliparity and the use of IV oxytocin, both of which are associated with more intense labor pain. Other factors contributing to increased pain during labor include younger maternal age, lower back pain during menstruation, and higher maternal or fetal weight. Women who have attended childbirth classes and those who have performed aerobic-conditioning exercises during the pregnancy may experience less intense labor pain.

The pain experienced during labor and delivery may prompt a number of bodily responses that can affect both the mother and the fetus. It is important, therefore, that the pain be effectively managed. Epidural anesthetics are the most popular form of pain management currently chosen by the patient during labor in the United States and the Philippines. The epidural anesthesia is administered by the anesthesiologist. 

The anesthetic is usually administered after the diagnosis of active labor has been established and the patient has requested pain relief. Most patients do not request an epidural before cervical dilation of 3 cm, unless they are receiving oxytocin for labor augmentation.

Other options include spinal anesthesia and general anesthesia depending on the clinical condition of the patient. 

On the other hand, one could go for a “natural birth”. This describes a vaginal delivery performed without medication. Pain control is provided by the obstetrician through coaching and giving local anesthesia (applied over the perineal area). 

Epidural analgesia is recommended for healthy pregnant women requesting pain relief during labor, depending on the woman’s preference. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body. Although compared to natural birth, this is more expensive as it entails not only professional help from the anesthesiologist to administer but also covers the materials to do so.

The general intent is properly manage the pain that accompanies labor and delivery. These are the two most common options open to our pregnant patients. 

Reference

About The Expert

DR. CHRISTIA PADOLINA, OB-GYN

Dr. Christia S. Padolina is the president of the Philippine Obstetrics and Gynecological Society (POGS) Foundation Inc. It is the premiere organization of obstetricians and gynecologists nationwide.

It was a dream come true for her to become a physician. Her mother was sickly and she had so much expectations on the healthcare system being on the other side of the equation. She is a graduate of the University of the East Ramon Magsaysay Memorial Medical Center. It was there that she realized that she wanted to become an obstetrician Gynecologist. She does not mind waking up in the wee hours of the morning as she finds delivering babies exhilarating. 

Her subspecialty in Ultrasound in Obstetrics and Gynecology in the University of New Mexico in USA paved the way for better maternal care. She is locally and internationally known advocate for safe motherhood.
 

The views and opinions expressed by the writer are his/her own, and does not state or reflect those of Wyeth Nutrition and its principals.