Sedation is exceptional in childbirth and can affect baby

The sedation of women for childbirth is exceptional and not recommended by doctors, according to experts consulted by the Sheet. The practice, in addition to preventing the mother from participating in the birth of the child, can also affect the baby.

In the early hours of Monday (11), anesthesiologist Giovanni Quintella Bezerra was arrested in the act for the rape of a woman who was drugged while undergoing a cesarean section. The patient’s sedation procedure was one of the reasons that led the nursing team to distrust the doctor.

According to experts, sedation in childbirth is extremely atypical and rare in any type of delivery, whether normal or cesarean, and is contrary to recommended medical practices. In addition, when sedative medication is needed, it is given in low doses so that the woman does not lose consciousness during childbirth.

“I have been working as an obstetrician for 33 years and I count on my fingers the cases in which the mother was sedated. It is an exceptional practice, used, for example, when the fetus is dead”, says Silvana Quintana, vice president of Sogesp (Association of Obstetrics and Gynecology of São Paulo).

Doctor Marcos Albuquerque, president of the SBA (Brazilian Society of Anesthesiology), explains that medical teams can only resort to sedation when there is consent from the patient.

“The priority is always not to sedate, but in some cases, light sedation can be used so that the mother can relax and minimize the stress of childbirth. But it is a minimal dosage, never to remove consciousness”, he says.

Silvana explains that sedation impairs the establishment of the mother’s first bonds with the baby. “If the woman is unconscious, she does not participate in the moment of the child’s birth. She does not experience the first minutes in which the bond with the newborn begins, which is to hold him in her lap, to have the first breastfeeding.”

“Just the sedation of patients without clinical indication and consent, could already be considered an obstetric violence for withdrawing from them the right to participate in the birth of their own child”, says the doctor.

Doctors explain that sedation is also not recommended because it can bring risks to the baby. As the medication circulates through the mother’s bloodstream, it affects the child.

“The sedative can cause the baby to be born with respiratory depression, more soft, sleepy and even need assistance from a neonatologist”, explains Albuquerque.

The anesthesiologist José Luiz Gomes do Amaral, president of the APM (Paulista Association of Medicine), says that the sedation of patients constitutes a deviation from the conduct of good medical practices.

According to Amaral, for more than 50 years, the international and national medical recommendation is to avoid sedation and even general anesthesia during childbirth. “It is something so exceptional and with so many contraindications that there is one case a year in a large maternity hospital.”

Specialists explain that most cesarean sections are performed with only local anesthesia, epidural or spinal anesthesia. Only in cases of emergency or medical contraindication, is the use of general anesthesia. According to the medical literature, this interference occurs in about 8.7% of cesarean sections.

According to information collected by the Civil Police of Rio, Bezerra’s practice was not for general anesthesia, but for sedation.

“There is an indication that sedation was performed as a means of committing the crime, as a means of making the victim totally vulnerable, unconscious and able to suffer violence,” said delegate Barbara Lomba, who is in charge. of investigations.

“From the reports of doctors and nurses that we heard, everything indicates that sedation was not necessary or was done in an excessive dose”, said the delegate. Bottles of the sedative used by the suspect were seized. The police will find out if the doctor doped patients unnecessarily.