What is the full name of the PDA

Birth with PDA: relieve labor pain

Every contraction brings you closer to your baby. It is up to you how much pain you want to endure. The most common pain treatment during childbirth is epidural anesthesia, better known by the abbreviation PDA. We will answer all the important questions you have on this topic.

What to expect Can I withstand the pain? Can i do it? Quite a few pregnant women plague themselves with fears and doubts about the birth. It is reassuring to be familiar with the common medicinal procedures during pregnancy, which can be used in addition to gentle aids for pain in labor. For example, epidural anesthesia, or PDA for short, is a pain therapy that is used in many deliveries - be it a natural birth or a Caesarean section - is used successfully.

This involves local anesthesia of the abdomen by means of a syringe at the level of the third or fourth lumbar vertebra, also called a knapsack syringe for simplicity. It offers women significant pain relief during childbirth. In many clinics, women giving birth can even determine the dose of anesthetic themselves at the push of a button and, if desired, switch off the PDA completely for the contractions. We'll tell you here how exactly all of this works and what risks epidural anesthesia can have for mother and child.

PDA - yes or no?

You decide for yourself whether or not you want an epidural to relieve the pain of childbirth. When you register at the hospital of your choice, you will be asked in a preliminary discussion whether you would like to use it for the birth. Usually, an anesthetist will explain the procedure and possible side effects to you. If this pain-relieving measure is basically an option for you, then your signature and declaration of consent are required. This does not necessarily mean that epidural anesthesia will be placed at birth. But in labor you have less time and nerve to spend on forms.

Even if you did not have a preliminary talk, there is of course the possibility of epidural anesthesia. The explanation then happens as soon as you express the wish. Some women ask for it quickly in the course of labor; others try for many hours with the Labor pains to cope until they can no longer take it or their strength dwindles. Others can do without it at all.

The experiences are different. Some gynecologists recommend that pregnant women not rule out a PDA from the outset, especially when giving birth for the first time. Not only because of the pain relief, but because epidural anesthesia can release cramps and blockages in the body and thus facilitate the birth. In all of this, it is important that you alone decide when it becomes too much for you and whether you want to be given the anesthetic.

However, there are also cases in which the PDA is not used entirely voluntarily. These can be among others:

  • Pre-existing diseases of the pregnant woman, especially of the cardiovascular system
  • Risk birth
  • as a partial anesthetic during a caesarean section

The anesthetic technique, on the other hand, cannot be used in expectant mothers who are allergic to narcotics or who have a blood clotting disorder.

When and how is it set?

Ideally, that is cervix only opened two to three centimeters when the PDA is put in place. But even if you want to try longer to cope with the pain, it is still possible. In Germany only an anesthetist is authorized to do it. It only becomes a problem shortly before the baby comes, in severe labor, because at this point she can hardly be laid. Then it usually no longer makes sense - because the child is there before the remedy has developed its effect.

First, the anesthetist waits for a break in labor. He asks you to "crouch" while sitting so that the vertebrae are stretched. If you can't sit well - the humpback also works when you are lying down. You should be comfortable enough so that you can hold still during the procedure. The anesthetist will now feel for your lumbar vertebrae and look for the right place to insert the needle. First he disinfects the skin and uses a small syringe with a skin anesthetic. With a needle that is about as thick as the one used to draw blood, the anesthetist then penetrates into the space of the hard skin of the spinal cord (not the spinal cord!). This is the so-called epidural space. You hardly feel any of it. A syringe with saline solution is attached to the needle. When the doctor is in the right place, he will squeeze this solution out of the syringe.

Now the syringe is removed and a soft plastic tube is threaded into the long needle and pushed into the epidural space. This is the catheter that is used to dose the narcotics and painkillers in a targeted manner. A bacteria filter is attached to the front end of the catheter to prevent germs from entering. Now the doctor injects a test dose of anesthetic. Wait a few minutes - then the test follows to see whether your legs are flexible. You also need your muscles with a PDA so that you can press. You can still feel the contractions, but soon they won't hurt anymore because the drug numbs the spinal nerves and thus blocks the transmission of pain from the body to the brain. The tube is now stuck to your back with a plaster and passed over your shoulder to the front and also fixed. So you are mobile, nothing pinches your back, and the active ingredient can easily be added.

How does the PDA affect childbirth?

After about 10 to 20 minutes, the PDA has developed its full effect. You can still feel your stomach getting hard during labor, sometimes also pressure and pulling, but the pain has gone or has been significantly reduced. Their intensity can be compared to the pain you feel during your period.

Now and then the anesthetic only works on the left or only on the right, the other side is still "awake". Then let me know immediately. It often helps if you lie on the side that is still painful so that the active ingredient can flow there. Or the doctor has to slightly correct the position of the catheter.

This form of pain treatment is now so highly developed that it does not, as has often been said, negatively affect the course of labor.

This is what the corresponding technology looks like:

Medical devices make you restless? So that you know exactly what is used for what purpose when giving birth with a PDA, we show you the devices you need in our picture show:

The accessories for the PDA:

6 pictures

Can I dose the effects myself?

The mixture and dose of the drug is calculated individually for you. Narcotics and painkillers are almost always evenly replenished using a small pump. If you want, you can do it yourself: via a push button on the pump. You decide whether you want to let the pain come and be completely "there" again for the last phase of the birth, the so-called expulsion phase. Or whether you want a little pain until the end. With the modern PDA, the anesthetic is carefully and precisely dosed. Therefore you can straighten up, even stand up. But you definitely need a support for this. Because the furry legs do not obey you as usual. But with a little help, you can even go to the toilet.

What side effects should I expect?

A warm feeling rushes through your legs, not uncomfortable and a sign that it will soon work. Because the nerves around the blood vessels in the legs also react to the anesthetic - they widen and more blood flows into them. Your legs start to tingle, feel limp and are no longer as flexible as they were before.

Headache or back pain can also be the result of numbness, as can itching and fever. Ultimately, the side effects depend on the choice of anesthetic. Your anesthetist will explain the details to you. It can also cause problems urinating. Then you will be placed in a catheter for a short time.

Does the PDA pose any risks for mother and child?

Because many vessels dilate under PDA, your blood pressure can drop. That would not be good for you and for the baby, because your circulatory system supplies it with. That is why the midwife regularly checks the values. A small device wrapped around your wrist makes this easy. However, only a few women need circulatory drugs. To be on the safe side, a cannula will be placed on your arm so that you can react quickly with an antidote in the event of a sharp drop in blood pressure. Only a small part of the active ingredients for the PDA get into your circulation. Children born under PDA are therefore just as fit as babies of mothers who have not received pain medication.

Is it true that I can't get a PDA with a tattoo on my tailbone?

That can happen. Some anesthesiologists refuse to give a PDA to women who decided to have a back tattoo at hip height before their pregnancy (such as the now somewhat discredited "ass antlers"). The reason: the puncture needle that is pushed into the area between the lumbar vertebrae can smuggle color pigments into the body. And nobody can estimate what the tattoo pigments can do in the sensitive cavity in the spine. Because this area, also known as the peridual space, is filled with cerebral fluid and has a particularly large number of nerve endings. Women who have already got rid of their tattoo by laser need to worry less: the scars that result are in most cases no obstacle for a PDA.

Conclusion: birth with PDA - standard or just something for cowards?

One should think that expectant mothers these days are not judged for their choice of how to give birth to their child. With the full pain of labor. Or more relaxed with a PDA. User Sabrina is outraged by the reaction of those around her: "By opting for a PDA, I became a wimp for other mothers!" The birth remains an individual experience that you shouldn't let yourself be talked about.Do not be unsettled by critical voices. Some women are more fearful than others. Choose the path that works best for you and seek advice as early as possible on the various methods of relieving labor pain. Often even gentle remedies help, such as massages, heat, acupuncture or a hypnosis.

Any questions about childbirth with PDA? In our Forum you will find answers - and nice people to exchange ideas!