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Generally many situations that are not even observed and remembered by the woman and that occur during labor (loss of body fluids, unusual postures, unusual verbal expressions, etc.) and which are an intrinsic part of a unique and primordial physical and emotional event in the its essence, can be interpreted in a different and variable way by people who are not directly protagonists of the event.

So much so that it is not exceptional to have to assist and support relatives of the pregnant woman who show signs of malaise up to loss of consciousness due to emotional shock during their presence in the delivery room.

The problems that have arisen and with careful and scrupulous observation described by the mother of the girl in labor are many and have made me reflect for a long time on the difficult art of obstetrics which is not only professional technical ability but communication, interpretation of the needs and desires of the woman who she relies on us to give birth, and also compassion in the sense of sharing in the feelings of the other.

Many decades ago pregnancy and childbirth were events of great danger for the life of the woman and the child so much so that centuries ago it was more dangerous to give birth than to go to war.

Today maternal mortality in Italy is one of the lowest in the world and is equal to 9 women per 100,000 births and neonatal mortality is equally minimal.

Consequently, having substantially solved the most serious problems related to maternity, it is our absolute duty, moreover reminded us in the recommendations of the WHO of the year 2018, to ensure that the birth event is not only a safe event but must also be an experience positive life for mum and dad.

The woman in labor must be supported and accompanied with love and kindness, she must be able to find a welcoming, serene, silent and peaceful environment because only in this way the most ancestral part of her brain can temporarily take over the neocortex and produce those neuroendocrine substances that favor physiological processes unchanged for millions of years, as well described by Michel Odent in his books.

The cerebral cortex, on the other hand, must be very active and ready to make quick and correct decisions in the care staff who must have the rational ability to recognize deviations from physiology, the onset of dangerous situations and know the appropriate interventions of the obstetric art to prevent or treat. any pathologies that can compromise the life or health of mother and newborn.

For millions of years what is written in the Bible has been realized where God turning to Eve who had reaped the forbidden fruit said: “I will multiply your pains and your pregnancies. With pain you will give birth to children. “

Today we have many extremely effective tools to control the pain of childbirth both for the latency phase and for the active phase and if necessary also for the puerperium.

We have techniques ranging from physical means (massages, applications of hot cloths, tubs with water, etc.) to pharmacological ones (opioids) up to invasive procedures such as epidural anesthesia.

These tools must be used appropriately, at the right times and according to the requests and needs of the woman.

Unfortunately, in the letter from the mother of the girl in labor it seems clear that at the birth point in question, the aspect of pain control, for reasons that I do not know, was not adequately addressed and by the time it was intervened it was too late.

We do not always know the real conditions in which our professionals work, often the workforce is undersized and the workload is excessive and now in all birth points it has become very difficult to ensure personalized and continuous assistance.

Unfortunately, when the biochemical cascade of pain is activated, it becomes increasingly difficult to control it because the person suffering from it has now entered a phase of physical and psychological refractory to analgesic aids which makes its action less effective.

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