Fall 2004
Ask the Experts
Managing Your Pain During Childbirth

I am expecting my first child in three months, and I’m wondering about pain management during delivery. Can you explain my options?

Dennis Buonafede, MD, chief of Obstetric Anesthesia in The Birthplace at Bridgeport Hospital, responds:

The choice of anesthesia during birth is a very personal decision, and you are wise to begin thinking about it in advance. Here are your choices, which you should discuss with your obstetrician:

  • Natural childbirth, in which no anesthesia is used.
  • General anesthesia (usually reserved for emergency deliveries), in which you remain unconscious through the delivery.
  • Epidural anesthesia, in which pain-relieving medication is injected into a space outside the spine. You remain awake, conscious, and pain free, and may even be able to walk. (This is the most effective form of medical pain relief.)
  • Spinal anesthesia—similar to an epidural, but its effects are felt much faster. You may feel numb and will need help in moving during the delivery. Spinal anesthetics are mostly used for delivery by cesarean section or when the use of forceps is necessary.
  • Sedation, which can be given as an injection (into a muscle), or intravenously (into a vein). This can help to decrease anxiety, improve relaxation, and will reduce, but not eliminate, pain.
  • Local anesthesia, an injection of local anesthetic to numb your perineal area (between the vulva and the rectum) in preparation for the moment of delivery.

Dennis Buonafede, MD
  For a brochure about the helpful services and expert care offered in The Birthplace at Bridgeport Hospital, please call us, 24/7, at 888-357-2396.  

Dealing with Diabetes

I’ve just been diagnosed with adult-onset diabetes. My primary care doctor keeps talking about control, control, control. Why is control such an important issue for people with diabetes?

Maria Guoth, MD, FACE (Fellow, American College of Endocrinolgists), of Bridgeport Hospital’s section of Endocrinology, responds:

To stay healthy, people with diabetes need to keep tight control over the amount of sugar in their blood. You can do this by eating properly and getting the right amount of exercise. Your doctor, along with a dietitian, will provide diet and exercise guidelines.

To stay in control, it’s important to follow your doctor’s instructions on how often and when to check your blood sugar levels, using your blood glucose monitor. Your doctor will tell you what your levels should be before and after meals, and what to do if your levels fall out of the desired range.

Don’t skip these important checks. The closer you stick to your schedule for checking, the tighter your control. Studies have shown that people who tightly control their diabetes stay in better health throughout their lives than those who give in to the temptation to "forget" one or more checks per day.

  Bridgeport Hospital offers a four-week diabetes self-management program called "Living Well with Diabetes." For information about the program, please call us, 24/7, at 888-357-2396.  

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