The question listed a few points, in fact, more or less affect the domestic labor analgesia to carry out.
Pregnant women don't know about painless labor and don't dare to try it. At least at present there are still a lot of people think that anesthesia will affect the IQ, there will be other kinds of effects, but labor analgesia is not general anesthesia as everyone understands, but is similar to epidural anesthesia, and there are not so many effects. But it's often the families who have these concerns, and when the pain comes, no pregnant woman wants no analgesia.
Not enough anesthesiologists?
This is an objective status quo, not only obstetrics and gynecology, even general hospitals, are faced with a shortage of anesthesiologists, anesthesiologists overloaded with the problem of surgery are too busy, so relatively not so urgent labor analgesia, anesthesiology, how to arrange the manpower is also a great test
Anesthesiologists treatment is low and unmotivated?
This is the main reason why I personally feel that the medical service charge is too low is not the first time to talk about, take the previous Beijing painless childbirth as an example, the public hospital charges are set very early, probably 200 / times, and then increased by 30 yuan per hour according to the time of a labor to calculate the average need for 10 hours, that is to say, the cost of a painless childbirth is about 500, but the anesthesiologist is required to continue to the woman in this 10-hour period. However, anesthesiologists are required to continue to monitor the mother during these 10 hours, and no one is willing to "dedicate" in this way. Therefore, it is usually necessary to charge a disposable consumable fee of a few hundred dollars, but it is still difficult to mobilize the enthusiasm of anesthesiologists, and it is already hard for them to do their work. So there are some hospitals that can carry out painless delivery during daytime working hours, but not at night. If you pay an anesthesiologist hundreds of dollars for a painless delivery like in foreign countries, this will not be the case.
So that's why the private hospitals are doing better than the public hospitals.
I'm an anesthesiologist, let me answer this question.
First of all, this is a false proposition. Most of the public hospitals are strongly recommending painless labor, especially in the evaluation of the three hospitals, the hospitals that do not have to carry out painless labor is a one-vote veto. In other words, all tertiary hospitals must provide painless labor and delivery services.
Why is the promotion of painless labor so bad? First of all, there is a shortage of anesthesiologists in all public hospitals. Our hospital has a shortage of 10 anesthesiologists, and many larger tertiary hospitals have an even larger shortage of tens of anesthesiologists. All the anesthesiologists are already overwhelmed with clinical surgery anesthesia, so I am not willing to divert my energy to a relatively simple but labor-intensive task - painless delivery. A clinical anesthesia usually takes about an hour, but a painless delivery usually takes up to several hours. So in many hospitals, anesthesiologists won't emphasize painless delivery if the mother doesn't insist on it.
Why are many private hospitals better at providing painless labor? Private hospitals emphasize service and enjoyment, they do not have too many patients, busy phenomenon. So they have time to give each patient service, and at the same time his fee for each service is different from the public hospital. A painless delivery in a public hospital is about a few hundred dollars, but a private hospital costs up to tens of thousands of dollars to give birth to a child. This is not a consumer level of service.
Then why are many women afraid to use painless labor? The first is that they are not familiar with painless labor. The second is that many public hospitals do not give priority to recommending painless labor, but rather recommend normal normal delivery. The third is the lack of cooperation between obstetricians and gynecologists and anesthesiologists, which has led to many painless deliveries not achieving the maximum effect.
The mother of the child said that her own experience of childbirth.
The hospital is not the same as our hospital!
The hospital, a tertiary hospital, obstetricians eagerly awaited painless delivery, to date there is no way to carry out, anesthesiologists said that the lack of work.
Many maternity hospitals are doing very well with painless delivery because the anesthesiology department is purely for mothers and newborns.
But in general hospitals, there are many clinical departments, and anesthesiologists need to serve many departments, so it is difficult to find the manpower to carry out obstetric painless delivery.
As a result, many women with no comorbidities prefer to give birth in a maternal and child health center rather than in a general hospital, where the pain of childbirth is absolutely unimaginable.
In the obstetrics clinic, you can see many women who swear to have a normal delivery, but because they can't stand the pain of contractions, they ask for a cesarean section. But the hospital on the cesarean section indicator control is very strict, many times and can not comply with the wishes of the mother in time cesarean section, even with the coaxing of the mother to give birth to the child, the pain. Only the mother herself knows best! The midwife is also very helpless.
In my humble opinion, painless childbirth should be carried out projects and maternal, childbirth satisfaction, as one of the criteria for assessing the level of obstetrics, included in the annual maternal and child inspection program.
The lack of anesthesiologists is indeed one of the reasons, but not all. Painless labor, which we also call labor analgesia, is the use of various techniques to reduce the pain of labor, and the one we most commonly use is intrathecal analgesia.
Intrathecal analgesia for labor is simply to inject local anesthetic drugs into the spinal canal and place an epidural catheter, connect the infusion pump, set the infusion rate, this analgesia until the end of labor, can effectively relieve maternal pain, and adverse reactions are relatively rare.
I myself received labor analgesia during labor and found it to be a really maternity-friendly technique. It can save the mother from severe labor pains. But many public hospitals do not offer labor analgesia, why?
The shortage of anesthesiologists is one aspect, as the whole process requires an anesthesiologist to be present, and a hospital has anesthesiologists who have to serve other surgeries, so there is a huge gap. In addition to this, patients do not understand enough, that painless labor will beat the child silly, will cause sequelae, etc., would rather endure the pain is not, or the family does not agree to play, is also a reason.
With the passage of time, painless labor will certainly become more and more popular. At present, many public hospitals have begun to vigorously publicize it, and I believe that more and more women will enjoy this benefit in the future.
President Ai believes that anesthesiologists are the watchmen under the shadowless lamps who are concerned with the lives on the operating table, but they are often neglected after a successful operation. The saying "surgeons cure diseases, anesthesiologists save lives" describes the importance of anesthesiologists' work, but in reality, according to President Ai, most hospitals still define it as a clinical auxiliary department that serves surgical procedures.
Anesthesiologists monitor the surgical process at all times, guarding the entire process
View related materials show that: in the 1980s, in order to save the lack of anesthesiology talent, more than 50 medical schools across the country opened the Department of Anesthesiology. In a specific historical stage, the Department of Anesthesia has cultivated a large number of anesthesia talents for the whole country. For example, Xuzhou Medical College, which was the first one to establish anesthesia department in China, has trained more than 3,000 anesthesia graduates for the whole country, and there are about 10,000 anesthesia graduates in medical colleges nationwide, and most of the backbones of anesthesiology departments in many large hospitals graduated from anesthesiology departments of these local medical colleges. However, many people in the field have called for the abolition of the Department of Anesthesiology, believing that the Department of Anesthesiology has lowered the standard of anesthesiologists and is a lack of attention to anesthesiology. Now, the anesthesia department is finally facing "closure", according to the plan, in 2016, the national anesthesia enrollment will be reduced by 50%, and by 2020, China will completely abolish the anesthesia program in colleges and universities.
Surgical volume has increased dramatically, and the workload has skyrocketed
Multidisciplinary collaboration is becoming more and more difficult
The workload has increased, and it is more difficult for departments to cooperate with each other, and between disciplines, and the difficulty of surgery has also increased, and the anesthesiologists need to have generalist knowledge because they are facing multidisciplinary surgeries. Anesthesia is the synthesis of various clinical departments. A qualified anesthesiologist should be a qualified clinical general practitioner first, and anesthesiologists should be the most knowledgeable doctors. At the same time, the doctor-patient relationship is tense, the burden of pressure on the doctor is very large, just out of the school of medical students and no physician's license, is the beginning of the certificate, the treatment is very low, so gradually the entire health care system will be very lack of useful talents, medical personnel echelon training can not keep up with the counter-hiring can be temporarily relieved, in fact, the training of medical personnel will be a vicious circle.
I was born a child to play the painless labor, the pain of the bout does reduce the pain, the birth of the doctor will give you to stop the anesthetic, otherwise no pain will not force, the mothers-to-be, I would like to give you the advice is that if your mother-in-law and her husband is not good to you, the month inside the need for you to do it with their own hands with the child, please do not play the painless, play the painless doctor will say that you want to the month inside! Don't hold the child, don't sit for a long time, don't be too tired, or you will get back pain later, I hired a sister-in-law to bring the month inside ten days, after the sister-in-law had something to do at home, I have to bring my own, my mother-in-law in addition to give me cooking, washing clothes, and bring people almost didn't do much to help me, and my husband has to go to work, at that time, I was not out of the month I had back pain, and now as long as the day cold, standing for a long time, menstrual period, wearing low-waisted pants, wear a short suit will be uncomfortable, I have to wear a back brace yesterday, I have a back brace. The first thing you need to do is to get your hands on some of the most popular products that you can find on the market, and then you can get your hands on some of the most popular ones! Simply put, painless labor does not benefit the hospital, so the hospital refuses! I have just experienced the request for painless labor was refused to push the guided instrument, half a point with no use, direct pain dizzy! Blood pressure soared more than 170 into pre-eclampsia emergency planing! First of all, I was in the same hospital from the time I made the card to the time I gave birth, and I did not miss a single checkup! Four o'clock in the morning began irregular pain (two minutes to five minutes or so once), six o'clock more red, eat breakfast at nine o'clock admission, two o'clock in the afternoon more than two centimeters open to ask for painless was rejected, reason: prolonged labor, the baby will have an impact on the recommended guided music instrument (a small broken electromagnetic wave rushing instrument two hundred yuan / clock) to four o'clock more than four centimeters open to the frequency of the pain of a minute or so once! Asked again to be pain free, refused! Suggested to ask for a manual guide ！！！！ I did not accept, then the midwife taught my husband to accompany me to use breathing to ease the pain, but for people like me who have too many bouts of pain, but it does not matter, my last impression is that I have not yet recovered from the previous wave of pain, the next wave of pain came again, and then I do not know ( _ ) during the period of pain to the point that tears have been flowing, the doctor did not come to re-examine the mother-in-law to go to find the doctor was also stopped. Woke up already in the operating room, the baby's crying a piece of white before my eyes, conscious but can not see people, the nurse sent the baby out before I put the face, asked me to see? I said I felt, but could not see [tears] until out of the operating room, the eyes are still hazy, blurred to see outside the operating room in addition to launch the day before yesterday, something temporary back home mom, all in the (then my husband told me that I said nonsense rolled his eyes, the doctor and then check has been six centimeters, advancing into the delivery room to try to labor has been uterine contraction weakness directly under the notice of the critical condition, he and the family grandmother were scared silly, the husband is). I'm not sure if I'm going to be able to do this, but I'm going to be able to do it," he said. While crying, I called my family.). He was then rushed to the ICU. The baby was only in her father's arms for a moment before being sent to the NICU (I was told that the baby was at high risk because of the Valium I was given after I passed out). I was transferred back to the OB ward after three days of intensive care, the baby was transferred to pediatrics after three days, and I got to see and hold my little princess for the first time when I went to the OB to have my ear strength measured and heel blood taken before being discharged straight home on the fourth day. During the period I was in normal condition, the highest blood pressure of more than 130, after taking Labet also returned to normal, the wound on the fifth day to go gauze on the waterproof adhesive, the eighth day in the morning discharged. After discharge from the hospital at home to test blood pressure is normal, 15 days community hospital door-to-door assessment back to normal, mother and daughter condition assessment good! The main thing I want to say is that if the hospital could have given me a painless, I believe I could have taken my daughter down, to be honest, in this Putian system of health care environment, hospitals want to make more money I think there is no excuse, however, to take the mother and the baby's life to gamble on the excessive! In-laws did not want to save money on me, even if the planed labor, analgesic stick, etc., not let me suffer too much (except in intensive care because of electromagnetic tablets allergic to all the scars and air mattress bed impermeable caused by a nevus [in the face]) Husband said that fortunately, I am fine and the baby, otherwise he did not know what to do, what will be done. So now I will also feel that some medical trouble is not unreasonable, part of the hospital doctors have lost medical ethics, the so-called medical parents have been an empty word 。。。。。。
Many skilled public hospitals are promoting painless labor! Painless labor means that the mother is given anesthesia during labor so that she does not feel the pain of labor. When labor is in the active phase, that is, after the uterine opening is 3-4cm wide, you can request a painless delivery. After evaluating a pregnant woman's suitability for a painless delivery, the anesthesiologist will give her an epidural anesthesia. The epidural catheter is used to release anesthetic drugs at regular intervals to block the mother's sensory nerves but not her motor nerves, which means that the mother can feel no labor pain or less labor pain, and at the same time have the strength to give birth, which is the ideal state for labor.
The situation you describe cannot be summarized in many such words. Because from the actual situation, on the contrary, many public hospitals in turn support painless childbirth, and use this indicator as a data, positive assessment.
And with the advent of the two-child era, if a woman who had a cesarean section, a second cesarean section child, there will be greater safety risks, so painless childbirth in the future of society, will certainly be the mainstream.
Simply put, public hospitals rely on technology to eat, most private hospitals rely on service and fool around. The public hospitals are more standardized in the whole process of delivery, as for the painless delivery, the technology is definitely not the reason, there must be other more professional reasons, or painless delivery of some of the drawbacks of the painless delivery can not be very good promotion, the specific on the more professional people to answer the answer. Why do private hospitals promote painless labor? Most of the private hospitals only publicize the benefits of painless delivery, but not the disadvantages. So be careful when you see a hospital that advertises all over the place.