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[静观]分娩之痛

2017-08-19 18:46:18   央广网

生命中总有那么几次,你希望自己身边有个“内行”。当年买春运硬卧火车票,最能检验各人铁路系统的人脉;到孩子上学的年纪,亟需一个教育系统的朋友;而最被周围人需要的职业,莫过于医生。除了希望争取质优价廉的医疗资源,许多人还寄望医生朋友能在具体的医疗问题上给自己出出主意——即使对方专业未必对口,但瘦死的骆驼比马大嘛。

要说这懂行和不懂行的差距有多大?昨天,广东顺德一家医院的产科医生小陆完成了自己给自己接生,全程顺产。和她同日分娩的女性朋友们简直要自惭形秽,人家不但顺顺利利生了,还一人分饰二角;看看自己,痛不欲生,别说接生、连说话都没劲儿。难道投身医学界,不但懂科学,还能对疼痛免疫吗?其实差别恰在小陆医生的一句话里,“打了麻醉后,不是很痛,过程算是轻松吧。”

“打了麻醉”,这个麻醉的学名“硬脊膜外麻醉”,没错,就是传说中的“无痛分娩”。这项在美欧全面使用、在国内也早已成熟的技术,可以阻断疼痛,但仍保持产妇的清醒,可以正常感受和用力,无痛地经历生育的全过程。此外,它对孩子非常安全,严重副作用的概率低于百万分之六。

感叹“隔着屏幕都觉得痛”的网友们,当你知道小陆医生本人其实并不怎么痛,“给自己接生”的创举是不是立刻失去了“悲壮”的意味?科学技术总比社会观念进步得更快,当许多产妇、尤其是其家人还沉浸在网上种种流言、还在纠结新技术对婴儿的利弊时,你看,“内行”的已经用脚投票了。

千百年来,分娩的疼痛都是母爱伟大的一大例证,但实际上,现代医学已经证明,这些疼痛大都是毫无必要的付出。据国家卫计委妇幼卫生年报的数据,2013-2015年,中国剖宫产率维持在34.3%到35%之间。除了明确具备剖腹产指征的产妇,其中想必也有耳闻目睹甚至亲身体会过顺产之痛而拒绝吃苦者。她们都被仔细告知了分娩镇痛的选择了吗?还是和大多数女性一样,仅仅被简单告知“忍一忍就过去了,大家都是这么过来的”?一台电饭锅20分钟能蒸好一锅米饭,一只小小的铝锅,盖上盖儿咕咚两小时,也能把饭煮熟。电饭锅和铝锅的优劣一目了然,怕只怕,卖锅的售货员并没有告诉你,世界上还有电饭锅这种东西。

许多医院、尤其是公立医院并不主动向产妇推荐无痛分娩,原因莫过于医疗资源的紧张。麻醉术需要麻醉医生的参与和护士的监护,客观上需要更多的人手;使用硬脊膜外麻醉平均会延长产程20分钟左右,无形中也增加了医院产床数量的压力。相比产妇刻骨铭心的疼痛,现实更残酷。作为“痛过者”,我多希望当年曾有医生认真向我介绍过无痛分娩。即便由于人手、床位种种原因,这项技术被定在了我无法接受的高价,我也希望,作出“不用麻醉”决定的人是我自己,而不是那整整一天一夜里,我压根不知道自己原本不必如此疼痛。(记者沈静文)

  *文中关于硬脊膜外麻醉专业内容参考自澳大利亚科廷大学公共卫生博士陈小舒微博@夏天的陈小舒。

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