Dr. Marty Vogt talks about the use of anesthesia during labor. He says women have two main options: general or regional anesthesia.
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Anesthesia during labor: the options Dr. Martin Vogt: Essentially, for any anesthetic there're two options. There is a general anesthetic, which most people are familiar with that they are coming to the operating room; the patient goes complete into sleep, wakes up in the recovery room at the end of the procedure. During that time, their brain is essentially complete with the sleep. The other option in which most pregnant women prefer, especially if they are having a C-section, but the other one is what we call regional anesthetic where put a region of your body to sleep. Primarily most of our anesthetics for obstetrics are regional anesthetics and that's either one of two, either an epidural or a spinal and essentially the difference between the two is the time that they last. The epidural is given and can be used for a prolonged period of time throughout the entire labor and it's sort of designed to keep the patients comfortable for even a very protracted labor, whereas the spinal is a relatively defined time period been an hour to hour-and-a-half, primarily used for C-sections. Anesthesia safety General anesthetic in obstetric patients is perfectly safe. What we limit is our options as to what we give the patients before and everything that we give any patient and IV into vein goes through the placenta to that infant. So, we want to limit what they get, so we wouldn't give them any medicines that help them relax before the procedure, we wouldn't give them any pain medications that would cause the baby to go to sleep prior to the surgery. So, if a patient did have to go to sleep for a C-section, we would put them to sleep right before the surgery started and that really give them only a minimum amount of medication prior to the delivery of the child just as we don't want to give any medicine that would cross the placenta and that affect the child. I want to reinforce that people have this option that it can be safely given to an obstetric patient, I mean there is really not a problem but just I think for our laboring patient really the only option we have is an epidural because it's a long acting anesthetic that we can control how much or how little the patient gets depending on where they are on the process. A spinal anesthetic, it makes the patients very comfortable and it's more of it and I would call it's probably a safer since we don't have to manipulate the patients early, but it's also a patient friendly anesthetic. And the patients are awake, they can sit there and talk with their family, then they can see their baby seconds after they are born and they can be comfortable throughout the process. So, it's more of I would call it a patient friendly anesthetic. Thoughts on natural childbirth If that something that I feel comfortable with then I think they should go ahead and do it. Obviously, there are fair numbers of ladies who begin that, and then say this is not something that I'm comfortable with anymore and we put epidural you know that's completely fine. I think people have to be comfortable with around the whole process on their own. Recommendation for expectant parents I mean what I would recommend is that most hospitals these days have a birthing class and it's usually run by that here in this hospital, its run by nurses who do obstetrics and they do an outstanding job, I think explaining all the options to the mothers. Like I said, it falls back to how I feel that if you want to have natural child birth, that's your decision I'm not going to influence at one way or other, but if you want an anesthesia, if you want anesthesia then I would be, at that point I would may come in and explain the option and explain what we are going to do.
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