Читать книгу Infants and Children in Context - Tara L. Kuther - Страница 170

Medication is administered in over 80% of births in the United States (Declercq, Sakala, Corry, Applebaum, & Herrlich, 2014). Several drugs are used during labor, with varying effects. Analgesics, such as tranquilizers, reduce the perception of pain. They may be used in small doses to relieve pain and to help the mother relax. However, these drugs pass through the placenta to the fetus and are associated with decreases in heart rate and respiration (Hacker, Gambone, & Hobel, 2016). Newborns exposed to some medications show signs of sedation and difficulty regulating their temperature (Gabbe et al., 2016). Anesthetics are painkillers that block overall sensations or feelings. General anesthesia (getting “knocked out”) blocks consciousness entirely; it is no longer used because it is transmitted to the fetus and can slow labor and harm the fetus.

Today, the most common anesthetic is an epidural, in which a pain-relieving drug is administered to a small space between the vertebrae of the lower spine, numbing the woman’s lower body. There are several types of epidurals, with varying numbing effects ranging from immobilizing the lower body to numbing only the pelvic region, enabling the mother to move about (a so-called walking epidural). Epidurals, however, are associated with a longer delivery, as they weaken uterine contractions and may increase the risk of a cesarean section, as discussed next (Gabbe et al., 2016; Herrera-Gómez et al., 2017). An analysis of nearly 15,500 deliveries suggested that newborns exposed to epidural anesthesia did not differ from those exposed to no anesthesia (Q. Wang et al., 2018). The American College of Obstetricians and Gynecologists (2017) has concluded that the proper administration of medication poses few risks to the newborn and pain medication should be available to all women.