Labour Analgesia. Pros”& Cons



Ivan Panasevich

The Libyan Board of Medical Specialities

JMJ Vol. 2, No. 4 (September 2003): 23-29


Although childbirth is a normal, natural physiologic process, most women experience pain. Pain associated with the labour and delivery is a stressful experience for both mother and child. There are numerous options available for labour pain control. Analgesia for labour and delivery is now safer than ever. Anaesthesia-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 labour. Each year million women choose ”epidurals” for safe effective pain relief. The use of epidural analgesia varies widely between countries. In many hospitals today the availability of regional analgesia for labour is considered part of standard obstetric care. There is a 20-30% ”epidural rate” for labour in Sweden and Finland, while in Denmark it is around 5-7% [40]. In the USA this varies between 65 and 90 % [23]. 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 labour, difficulty in organizing an obstetric analgesia service, limited technical knowledge among anaesthesiologists and staff shortage issues. This paper is addressed to medical community of Libya. It outlines the following aspects of labour pain control:

• Origin of labour pain.
• Indications &contraindications for epidural analgesia.
• Techniques &drugs.
• Benefits of epidural analgesia.
• Effects of epidural analgesia on labour and neonate.
• Problems and complications.

Keywords: epidural analgesia, labour pain