-07- Frequently Asked Questions

Q

What kind of method is "epidural anesthesia?"

A method primarily for relieving the pain of contractions by injecting anesthesia through theback, into the neural pathways near the spine.

It is a method also normally used in various kinds of operations, and for the purpose ofQ

Seven Things About Painless Delivery

post-operative painkilling.

Painless delivery is a method to reduce pain as much as possible

What will happen after childbirth?

In western countries it is often chosen as a matter of course, butwhile retaining the sense of giving birth.

even in Japan more and more people are learning about it, andThe eﬀect of the anesthesia will wear oﬀ a few hours after the injection is stopped.

we oﬀer the option of painless delivery at our clinic.

Afterwards, you will spend the time with your baby on the same schedule as with natural childbirth.
※ The length of the hospital stay will vary by clinic, so please check with the staﬀ.

Q

Can anyone receive painless delivery?

Generally, anyone can receive it, but some mothers may not be able to depending on their condition.
In the Bell Network, we will conﬁrm patients' desire for painless delivery, and explain the details tothem, during the outpatient midwife consultation. If you would like to receive painless delivery, or are
considering it, please feel free to consult with the midwife.

Out-patient Midwife Consultations

1st time

2nd to3rd times

Explanation of painless deliver y to those considering it, or are unsure of it.

We will give further explanations if there is any uncertainty or unclear issues.
The ﬁnal decision for painless deliver y will be made here.
※ The doctor will explain and provide a consent form.

※We are also happy to address any other concerns about issues other than painless deliver y,such as life during pregnancy, admission into the hospital, or childbir th.

I chose painless deliver y because,unlike with my ﬁrst child,
I was worried about my physical ﬁtness.

It took time for the anesthesia to take eﬀect,
and there was still some pain,
but when I think that the pain could have been even worse,
I feel glad to have chosen painless deliver y.
I was scared of the pain, and chose painless deliver y after
much deliberation. The staﬀ were all so kind,and I was able to give birth calmly, without panicking.
The concerns I had about possible side-eﬀects
were carefully addressed.

Among the few clinics oﬀering painless deliver y,I wasreassured by the system being super vised by an anesthesiologist.

-01- Painless delivery in Japan and Overseas
Fran ce82 %The cultural background and obstetric medical system in

60 %er, in recent years, as the culture itself has begun toJapan is diﬀerent from overseas and so the widespread73 %th e USth e UK

usage of painless delivery has not been as rapid. Howevchange and the government has actively been working to50 %Sin gap ore

improve the safety of painless delivery, the number of40 %Korea

facilities oﬀering this service is also increasing.

6%

J apan※ Ta ke n fro m " Pa i nle s s D e li ve r y Q &A"

by t he J a pa n S o c i et y fo r O b stet r i c Ane st he s i a a nd Pe r i nato lo g y (J S OAP ) .

The topic was widely discussed in

J a p a n w h e n i n 2 01 8 , D u c h e s s K a t e
Middleton gave bir th by painlessdeliver y.

-02- Painless Delivery in the Bell Network

367
2019

cases

486
2020

cases

761
2021

cases

※ N umb e rs fo r a ll c li ni c s i n t he B e ll N et wo r k g ro up.

While t h e p e rce nt age of wome n using painle s s deli ve r y is s t ill low in Japan, in t h e B ell Ne t wor k

the number of painle s s deliver y bir ths is increasing ever y year. The reas ons are var ious , such as

painles s deliver y it self becoming more widely known from public ﬁgures using it to give bir th, orwo m e n g i v ing b ir t h late r in lif e a n d b e ing un s ur e a b o u t t h e ir p hy s i c al ﬁ t n e s s f o r c h ildb ir t h , o r

wanting to cons er ve their energ y s o that they can get us e d to life with their baby in the hospit al
before retur ning home. We hope you will add "painle s s deliver y" to your childbir th options , andtalk with your doc tor or midwife/nur se if you any ques tions or concerns .

-03- Characteristics of Painless Delivery in the Bell Network
Point

1Management system
by anesthesiologists
We give our staﬀ technical training in painless delivery under the management of anesthesiologists.

We have a fully prepared management system torespond in case of emergencies.

Point

2

Regulation of pain
during childbirth

Because painless delivery is done with local anesthesia aﬀecting
only the lower body, rather than general anesthesia, the motherretains full awareness.

While it is called "painless delivery," because labor will stop if

the sensation of pain or bearing down is completely eliminated,
we manage the amount of anesthesia so that the mother cangive birth calmly while regulating the pain.

Point

3

Point

4

Less taxing,
quick recovery.

Virtually no aﬀect of themedication on the baby.

The burden of labor pains can sometimes be too

B e c aus e it is a lo c al an e s t h e t ic r at h e r t han a ge ne r al

By maintaining their energ y over a long period

mother is quite low, with virtually no aﬀect on the baby.

much on mothers.

by reducing pain, mothers can be more at ease

There may be some additional charges depending on leng th of hospital stay or time of labor.

We are dedicated to training
our s taﬀ so that mother s
can give bir th withpeace of mind.

-04- For safe painless delivery
I believe there are some mothers who, after reading of recent incidents related to painless delivery,
may have a fearful impression of the procedure. In almost all cases of emergencies immediately
following administration of anesthesia, it is the result of local anesthesia entering the subarachnoid

Chief Anesthesiologist

Eiichi Sato

The rate of cesarean sections remains unchanged. While the anesthetic has no direct eﬀect on the baby, there is a chance thebaby may experience increased strain from the prolonged labor.

Painless delivery cannot be done (or will be discontinued) in the following situations:● If the baby loses vitality● If there is a possibility of infection
We will e xplain the s e● If the mother is severely physically exhausted or dehydrated
in det ail dur ing● If tests indicate there is a chance of excessive bleeding
your midwife
consult ation.
● If the mother has some forms of heart disease(e.g., aortic stenosis or hypertrophic cardiomyopathy)● If the cervix is already fully or nearly fully dilated and delivery is in progress● If severe lumbago is already present before delivery● If the catheter cannot be inserted due to patient being overweight, or a curve in the hipbone※ In addition to the above, depending on the hospital situation, such as emergency cases,
we may not be able to accommodate you.

Furthermore, it is possible that the below complications may occur for the mother.
● Temporary complications: low blood pressure, headache, lumbago, nausea,
diminished sense of needing to urinate, abnormal feelings in the legs, etc.
● Severe complications (extremely low frequency): Aforementioned anesthesia in subarachnoid cavity,
local anesthetic poisoning (in these cases, emergency measures will be taken,
and in some cases it may be necessary to do a cesarean section delivery.)Paralysis from nerve damage or compression, etc.

-06- How exactly is it done?
Timing of Commencement
Epidural Anesthesia

Please inquire at reception for more details.

Kishokai Medical Corporation

As a result, there is increased frequency of ultimately needing vacuum/forceps delivery or use of contraction inducing agents.

We generally begin the procedure when contractions become strong and regular.

5

Cost is 100,000 yen in addition
to the regular delivery cost.

Because contractions will get weaker the more pain is reduced, the progress of childbirth (time of labor) will increase.

anesthetic, the blood concentration of anesthesia in thein body and mind.

Point-05- Cautions regarding painless delivery①Because typically you will be fasting, we will start an IV before beginning anesthesia.
②You lie on your side on the delivery table, and after applying a local anesthetic,

a needle is inserted in your back, and a catheter is aﬃxed to the epidural cavity.

③Some anesthetic will be introduced as a test, and the situation will be monitored for ill eﬀects.
④If there are no ill eﬀects, then a ﬁxed amount of anesthetic is injected.

⑤The anesthetic will be continuously administered via a machine (injection pump).
The anesthetic will be adjusted in a timely manner according to its eﬀectiveness.

Planned deliver y is one option, to reduce the chance of missing the right timing for painless deliver y.

In the case of a planned deliver y, the above ① to ③ are done, then induction of labor is done using contraction inducing

agents, and when contractions become full-ﬂedged, ④ to ⑤ are carried out. In the case of a planned deliver y, it may takesome time before the contractions become full-ﬂedged.Because contraction inducing agents are used, you will be given aseparate consent form on the risks accompanying induction of labor.

During Labor①To reduce the risk of complications, there will be limitations on meals. Because there is also the risk of falling down,
we will have you lie in bed; as you will not be able to go to the toilet, a catheter will be inserted into your bladder.

cavity, or local anesthetic poisoning from anesthesia being administered directly into a blood vessel.

②You will lie on your side, changing facing at times so that the anesthesia does not all go to one side,of the procedure that guides the close observation of the patient's awareness, blood pressure, and③When the cervix is fully dilated, you will lie face-up, breathe as instructed by the midwife,

In the Bell Network, we work to prevent such incidents in advance by maintaining a thorough manualeﬀectiveness of the anesthesia while administering it a little at a time.

and wait until the cervix is fully dilated.

and push. Pushing is done just as in typical childbirth.

④After the baby is born, you will be able to be in contact with the baby normally.

⑤When childbirth is complete, the catheter will be removed from your back. The process afterward is as usual.