survey
The penetration rate of labor analgesia has increased.
But it is still at a low level.
It is understood that painless delivery is actually labor analgesia, which means that through the application of appropriate analgesic techniques and analgesic drugs or psychotherapy, the pain and adverse stress reactions of pregnant women during childbirth can be alleviated, so that the fetus can deliver smoothly.
Qu Yuan, chief physician of anesthesiology department of Peking University First Hospital, is also a mother. She personally experienced the tangible benefits of labor analgesia, "which can make more women become more dignified and dignified mothers".
2065 438+08 10 month, 1 1, the National Health and Wellness Committee issued the Notice on Carrying out the Pilot Work of Labor Analgesia. 20 19 March, 9 13 hospital became the first batch of national pilot hospitals for labor analgesia. According to Mi Weidong, head of the labor analgesia expert working group of the National Health Commission, at the end of 20 17, the painless delivery rate in these pilot hospitals was about 27.5%, and after three years' efforts, it will reach 53.2% by the end of 2020.
Chen Xinzhong, deputy dean of the Obstetrics and Gynecology Hospital affiliated to Zhejiang University School of Medicine, said that in the past few years, we should vigorously publicize the advantages of labor analgesia. Now more and more parturients are asking for labor analgesia.
Labor analgesia makes more women have the confidence and physical strength to have children, and no longer blindly choose cesarean section. Chen Danqing, director of obstetrics department of Zhejiang University Maternity Hospital, said that the popularization of labor analgesia reduced the cesarean section rate by about 10 percentage points.
"In the past, people had some wrong ideas that anesthesia would affect children's intelligence, leading to poor maternal memory and insufficient milk. Through popular science in recent years, these statements have become the past tense, and labor analgesia has become the first choice for doctors, mothers and their families. " Chen Xinzhong said that about 70% of women who give birth naturally in this hospital will choose the method of labor analgesia.
During the two sessions this year, Huang Yuguang, a professor at Peking Union Medical College Hospital, mentioned that the average penetration rate of labor analgesia in China is around 30%. Although this figure has been greatly improved compared with the national average of less than 65,438+00% in 2065,438+08, compared with the proportion of 80% to 90% in developed countries, China's penetration rate is still low, with significant differences between the east and the west, as well as between different regions in the same province.
fathom the cause (of)
Shortage of related doctors
The charging standard is not clear and it is difficult to popularize.
Many interviewed experts said that the promotion of labor analgesia still faces some difficulties. The first is the shortage of anesthesiologists and midwives. Mi Weidong believes that the first difficulty in promoting labor analgesia is the shortage of personnel, especially anesthesiologists.
According to the statistics of Anesthesiologists Branch of Chinese Medical Association from 2065438 to June 2009, the number of anesthesiologists in China is 92,000, with an average of 0.6 anesthesiologists per 10,000 people, while there are 2.5 to 3 anesthesiologists (or anesthesiologists) per 10,000 people in developed countries.
In recent years, the demand for anesthesia in China's medical care has been rising, and the workload of anesthesia has increased dramatically. The demand for painless gastrointestinal endoscopy in China has reached hundreds of millions of people every year, and the number of various operations is increasing at the rate of 10% every year. Although the number of anesthesiologists is increasing, it is still not enough to support the needs of clinical anesthesia.
In addition to drug analgesia, other non-drug analgesia methods, such as Lamaze breathing, acupoint massage and aromatherapy, are mainly implemented by midwives, and the shortage of midwives has become another constraint to promote labor analgesia.
Yin Ling, chief physician of Obstetrics and Gynecology Department of Peking University No.1 Hospital, went to Guangyuan, Sichuan, and found that there was no midwife in a local hospital. Because of the blind choice of cesarean section in the past, the midwifery skills of many midwives and obstetricians have been seriously degraded.
In addition, Qu Yuan mentioned that the difficulty in promoting labor analgesia at present is not in technology, but in the way of cross-departmental cooperation. "This is not a question of anesthesiology. It requires multidisciplinary cooperation such as obstetrics and neonatology, and requires management coordination and policy support. "
Before deciding to popularize labor analgesia in 2020, the rate of labor analgesia in the Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology was only about 10%, and it was 5438+0 in 2026, which reached about 60%. Dean Tong introduced that a reasonable distribution of benefits is a key step. In the past, all the bonuses for labor analgesia in this hospital belonged to the anesthesiology department. Now this hospital divides the bonuses equally between obstetrics and anesthesiology departments. At the same time, this bonus is no longer distributed twice in the department, but is directly distributed to individual doctors who implement labor analgesia.
"The situation in many provinces and cities shows that if the charging standard can be well implemented, the proportion of labor analgesia will be improved to varying degrees." Mi Weidong said.
expert
Let labor analgesia be further popularized
Solve the pain of female fertility
Many experts said that at present, China's labor analgesia technology is very mature, with strong analgesia and high safety factor. The mainstream spinal block labor analgesia can help most parturients to relieve 60% ~ 90% pain, and its application range is very wide. It can be used by most parturients who have passed the evaluation of obstetrics and anesthesiology.
"The anesthetic used for labor analgesia is not through blood, but through nerve block, and the amount of anesthetic used for labor analgesia is very small, only about one tenth of that of cesarean section. It can be said that it has little impact on the fetus and is very safe." Qu Yuan said.
Faced with the shortage of anesthesiologists in hospitals, Mi Weidong said that it is necessary to speed up the improvement of the training mechanism for anesthesiologists and attract more young talents to join the field of anesthesiology. At the same time, anesthesiologists should strengthen the study and update of labor analgesia knowledge, understand and master the new technology in the field of labor analgesia, develop and expand new anesthetic drugs and equipment, improve anesthesia management and improve the efficiency of anesthesia medical service.
Chen Xinzhong suggested that it is necessary to increase the number of anesthesiologists and midwives in general hospitals and establish a collaborative team composed of anesthesiologists, obstetricians, midwives and anesthesiologists. As service providers, hospitals should think about how to expand their service capabilities, and at the same time, they should continue to correct the concept of cesarean section in primary medical institutions.
Li Fang, deputy director of the Talent Exchange Service Center of the National Health and Family Planning Commission, said that Tianjin, Beijing, Hunan, Chongqing, Hubei, Liaoning and other places have clearly introduced special fees for labor analgesia. With the introduction of charging standards in various provinces, autonomous regions and municipalities, it will further promote the popularization of labor analgesia in China. The hospital should pay attention to it and give financial support to the relevant departments of labor analgesia. "Promoting labor analgesia is a medical treatment with temperature and dignity, and it is the embodiment of the progress of medical concept in China." Li Fang said. This group/Xinhua News Agency