Labor analgesia. pros and cons

ABSTRACT

Although childbirth is a normaL natural physiologic process, most women experience pain Pain associated with labor and delivery is a stressful experience for both mother and child. There are numerous options available for labor pain control. Analgesia for labor and delivery is now safer than ever. Anesthesia-related maternal mortality has decreased from 4.3 per million live births during 1979 -1981 to less than 1.5 per million live births during 1990-2000 [2. 20]. Epidural analgesia is the most effective method of controlling pain throughout all stages of labor. Each year millions women choose "epidurals" for safe and effective pain relief. The use of epidural analgesia varies widely between countries. In many hospitals today the availability of regional analgesia for labor is considered part of standard obstetric care. There is a 20-30% "epidural rate" for labor in Sweden and Finland, while in Denmark it is around 5-7% [40]. In the USA this varies between-65 and 90% [231. The differences do not reflect actual need for obstetric analgesia. They represent different attitudes to obstetric pain relief in medical circles and in society. Epidural analgesia has not enjoyed widespread acceptance in Libya for several reasons; lack of information available to pregnant women, reluctance by obstetricians, who consider that epidural analgesia may prolong labor, difficulty in organizing an obstetric analgesia service, limited technical knowledge among anesthesiologists and staff shortage issues. This paper is addressed to medical community of Libya. It outlines the following aspects of labor pain control oOrigin of labor pain. oIndications and contraindications/or epidural analgesia. oTechniques and drugs