Max
07-03-2002, 10:02 AM
Labour Does Not Have to Be Painful
New Vision (Kampala)
ANALYSIS
July 2, 2002
Posted to the web July 2, 2002
By Angela Kamugasa
Women today have more options to stop or control the excruciating pangs of childbirth. Expectant mothers usually get anxious about childbirth. Nancy, a mother of a teenage daughter, says, "My labour was very traumatic. I was in labour for 24hours. Two nurses were holding my legs because I was too weak. By the time the baby was delivered, my legs were shivering the whole experience was terrible," she says.
Women need not go through childbirth without support, observes, Dr Catherine Lalobo-Lore, a consultant obstetrician and gynaecologist at the International Air Ambulance (IAA) in Kampala.
Women are now supported during childbirth, so it can be a better experience. Our local hospitals allow spouses, sisters or a friend of the mother to be by her side during childbirth.
Company helps reduce pain. Rose, a mother of three had her second baby from Jinja hospital, she says, "My close friend accompanied me to the labour ward where she rubbed my back as labour progressed. This reduced my discomfort."
"When people narrated their childbirth experiences, it was terrifying especially as a first time mother. My experience was not bad. I felt faint jabs of discomfort in my lower back. I tried to get to sleep the faint jabs could not let me, they became frequent as labour progressed, I kept tossing from side to side on my iron hospital bed.
A midwife brought me a Transcutaneous Electrical Nerves Stimulation (TENS) machine and instructed me on how to use it to numb the pain. The TENS machine worked for me." This is Nyakaisiki's experience at the International Hospital Kampala (IHK).
Dr MarieAnn Calnan, a medical officer at IHK, says the TENS works for some mothers and it does not for others.
She explains, "The TENS machine is placed in an anatomical position of the uterus. Then it gives off little shocks, which block off the sensory nerves numbing pain.
"Depending on how severe the contractions are, one may require a high frequency. You switch on the machine at least five to 10 seconds before the next contraction for efficiency. The TENS machine does not work for some mothers because people have a different thresholds for pain," Dr Calnan observes.
Dr David Akaki Nekyon, an anaesthetist at Mulago hospital, reveals: "I cannot recall any side effects off hand because we do not use this method in Mulago."
Women have more options to stop or control the excruciating pangs of childbirth. Some are available in our local hospitals but you need to ask for it.
An epidural is a pain relief administered with caution. A local anaesthesia is administered in your back to numb the pain. The anaesthetist inserts a fine, hollow needle into the epidural space, the region around the spinal cord inside the spinal column. A thin tube known as a catheter is threaded down inside the hollow needle. The needle is then removed leaving the catheter firmly taped in position. Anaesthesia is then syringed down the catheter, which is sealed. It can be topped up when necessary. The anaesthesia takes effect within a few minutes.
Dr Lalobo states a patient signs a form after being educated on the advantages and disadvantages of the method. This helps the woman to make an informed choice.
Stella, who recently had her baby from the United States of America, says: "When the pain was too much I asked for an epidural. It worked almost immediately, I was numb from waist down. I fell asleep in between the contractions, would wake up to push."
Dr Lalobo-Lore, reveals that, epidural has been used at Lacor hospital in Gulu for operations done below the diaphragm but not for childbirth.
The side effects of using an epidural vary. You could develop a urinal problem like urine retention or leakage. Or spinal cord injury and a shooting pain from your back down to your leg, when it has not been carefully administered. The main causes of pain are emotional, functional and physiological. The emotional pain can be due to fear of the unknown or lack of education on childbirth. Education helps combat pain but will not eliminate it.
"I did a lot of reading, toured the birth facility and discussed my anxiety with care providers," Nyakaisiki, adds. This is recommended so the expectant mother is on familiar ground when her baby is due.
For a stress free labour with less pain, the midwife should establish rapport with the expectant mother. "This encourages relaxation and relieves anxiety," explains Professor Specioza Mbabaali head of department of nursing, faculty of medicine, Makerere University.
Functional pain, occurs when muscles of your cervix dilate. This can be reduced by relaxation. Holding your breath and fighting contractions can hinder dilation and labour, thus more pain by depriving the uterus of oxygen and creating tension.
Nitrous oxide, softens the uterus during contractions lessening the pain. Dr Calnan, advises that nitrous oxide should be a concentration of 50%. The mother should inhale it using a mask as she feels the contraction coming on. The side effect is that it makes the mother drowsy.
The physiological source of pain occurs when one gets a back labour caused by the posterior baby (positioning of baby). Encouraging the baby to turn with the use of varied positions reduces pain.
Squatting and reclined positions ease pain because gravity helps pull the baby down reducing the pain.
Mbabaali, advises that the mother lying on her side is in a more comfortable position. This is in the first stage of labour.
Juliette had her baby at Mengo hospital, she was allowed to move up and down which helped distract her from the pain. "I walked uphill and downhill as the contractions came on," she says. Mbabaali, recommends that a mother in the first stage of labour remains mobile to ease pain.
Dr Mariam Stoppard's Conception, Pregnancy and birth, reveals that birthing pools are a means of pain relief.
The actual birth is under water however there can be some danger especially when the baby's head is not lifted out right away.
To numb pain, use of opiates like pethidine and petazocine can be administered when the cervix has dilated from six to seven centimetres.
Dr Nekyon, states, "These are strong pain killers. We do not encourage their use because they can depress the baby's breathing. But we give it after delivery."
Dr Lalobo, adds, that pethidine can be used from 50 to 100milligrams to reduce pain. It can be used as management of labour making the experience better.
"We give it as late as possible otherwise when given early, you could get what we call a floppy baby. It needs to be administered in the right doses when injected in the muscle or vein," says Dr Calnan.
A floppy baby is one who after birth does not scream or cry. This means that something is wrong with the baby. Dr Nekyon reveals that this may mean that the baby has been injured during delivery or does not have enough oxygen. A baby should cry and be active immediately it is born.That is a healthy baby.
New Vision (Kampala)
ANALYSIS
July 2, 2002
Posted to the web July 2, 2002
By Angela Kamugasa
Women today have more options to stop or control the excruciating pangs of childbirth. Expectant mothers usually get anxious about childbirth. Nancy, a mother of a teenage daughter, says, "My labour was very traumatic. I was in labour for 24hours. Two nurses were holding my legs because I was too weak. By the time the baby was delivered, my legs were shivering the whole experience was terrible," she says.
Women need not go through childbirth without support, observes, Dr Catherine Lalobo-Lore, a consultant obstetrician and gynaecologist at the International Air Ambulance (IAA) in Kampala.
Women are now supported during childbirth, so it can be a better experience. Our local hospitals allow spouses, sisters or a friend of the mother to be by her side during childbirth.
Company helps reduce pain. Rose, a mother of three had her second baby from Jinja hospital, she says, "My close friend accompanied me to the labour ward where she rubbed my back as labour progressed. This reduced my discomfort."
"When people narrated their childbirth experiences, it was terrifying especially as a first time mother. My experience was not bad. I felt faint jabs of discomfort in my lower back. I tried to get to sleep the faint jabs could not let me, they became frequent as labour progressed, I kept tossing from side to side on my iron hospital bed.
A midwife brought me a Transcutaneous Electrical Nerves Stimulation (TENS) machine and instructed me on how to use it to numb the pain. The TENS machine worked for me." This is Nyakaisiki's experience at the International Hospital Kampala (IHK).
Dr MarieAnn Calnan, a medical officer at IHK, says the TENS works for some mothers and it does not for others.
She explains, "The TENS machine is placed in an anatomical position of the uterus. Then it gives off little shocks, which block off the sensory nerves numbing pain.
"Depending on how severe the contractions are, one may require a high frequency. You switch on the machine at least five to 10 seconds before the next contraction for efficiency. The TENS machine does not work for some mothers because people have a different thresholds for pain," Dr Calnan observes.
Dr David Akaki Nekyon, an anaesthetist at Mulago hospital, reveals: "I cannot recall any side effects off hand because we do not use this method in Mulago."
Women have more options to stop or control the excruciating pangs of childbirth. Some are available in our local hospitals but you need to ask for it.
An epidural is a pain relief administered with caution. A local anaesthesia is administered in your back to numb the pain. The anaesthetist inserts a fine, hollow needle into the epidural space, the region around the spinal cord inside the spinal column. A thin tube known as a catheter is threaded down inside the hollow needle. The needle is then removed leaving the catheter firmly taped in position. Anaesthesia is then syringed down the catheter, which is sealed. It can be topped up when necessary. The anaesthesia takes effect within a few minutes.
Dr Lalobo states a patient signs a form after being educated on the advantages and disadvantages of the method. This helps the woman to make an informed choice.
Stella, who recently had her baby from the United States of America, says: "When the pain was too much I asked for an epidural. It worked almost immediately, I was numb from waist down. I fell asleep in between the contractions, would wake up to push."
Dr Lalobo-Lore, reveals that, epidural has been used at Lacor hospital in Gulu for operations done below the diaphragm but not for childbirth.
The side effects of using an epidural vary. You could develop a urinal problem like urine retention or leakage. Or spinal cord injury and a shooting pain from your back down to your leg, when it has not been carefully administered. The main causes of pain are emotional, functional and physiological. The emotional pain can be due to fear of the unknown or lack of education on childbirth. Education helps combat pain but will not eliminate it.
"I did a lot of reading, toured the birth facility and discussed my anxiety with care providers," Nyakaisiki, adds. This is recommended so the expectant mother is on familiar ground when her baby is due.
For a stress free labour with less pain, the midwife should establish rapport with the expectant mother. "This encourages relaxation and relieves anxiety," explains Professor Specioza Mbabaali head of department of nursing, faculty of medicine, Makerere University.
Functional pain, occurs when muscles of your cervix dilate. This can be reduced by relaxation. Holding your breath and fighting contractions can hinder dilation and labour, thus more pain by depriving the uterus of oxygen and creating tension.
Nitrous oxide, softens the uterus during contractions lessening the pain. Dr Calnan, advises that nitrous oxide should be a concentration of 50%. The mother should inhale it using a mask as she feels the contraction coming on. The side effect is that it makes the mother drowsy.
The physiological source of pain occurs when one gets a back labour caused by the posterior baby (positioning of baby). Encouraging the baby to turn with the use of varied positions reduces pain.
Squatting and reclined positions ease pain because gravity helps pull the baby down reducing the pain.
Mbabaali, advises that the mother lying on her side is in a more comfortable position. This is in the first stage of labour.
Juliette had her baby at Mengo hospital, she was allowed to move up and down which helped distract her from the pain. "I walked uphill and downhill as the contractions came on," she says. Mbabaali, recommends that a mother in the first stage of labour remains mobile to ease pain.
Dr Mariam Stoppard's Conception, Pregnancy and birth, reveals that birthing pools are a means of pain relief.
The actual birth is under water however there can be some danger especially when the baby's head is not lifted out right away.
To numb pain, use of opiates like pethidine and petazocine can be administered when the cervix has dilated from six to seven centimetres.
Dr Nekyon, states, "These are strong pain killers. We do not encourage their use because they can depress the baby's breathing. But we give it after delivery."
Dr Lalobo, adds, that pethidine can be used from 50 to 100milligrams to reduce pain. It can be used as management of labour making the experience better.
"We give it as late as possible otherwise when given early, you could get what we call a floppy baby. It needs to be administered in the right doses when injected in the muscle or vein," says Dr Calnan.
A floppy baby is one who after birth does not scream or cry. This means that something is wrong with the baby. Dr Nekyon reveals that this may mean that the baby has been injured during delivery or does not have enough oxygen. A baby should cry and be active immediately it is born.That is a healthy baby.