In more than half of Polish labor wards, anesthesia for childbirth was not administered even once throughout 2022. For hundreds of women, this means excruciating pain that shouldn’t be there.
In Krakow, the Gynecology and Obstetrics Hospital named after Rafał Czerwiakowski, 83 percent of women received anesthesia for childbirth in 2022. This is the best result in Poland. – I cannot imagine that I could refuse this anesthesia to a patient for childbirth – says doctor Paulina Marcinek-Tyburska, a gynecologist from the Rafał Czerwiakowski Gynecology and Obstetrics Hospital in Krakow.
The Krakow hospital is a notable exception. The situation in the country is dire. Out of nearly 348 delivery rooms across the country, 195 did not perform a single epidural anesthesia in 2022. They were performed by 153 delivery rooms, but 50 of them performed only a few of these anesthesias. This is official NHS data. – Women should simply avoid such hospitals. In the 21st century, it is a shame for the system and for doctors, for hospitals, that women give birth in pain – says Zbigniew Swoboda, head of the Department of Anaesthesiology and Intensive Care at the Complex of Municipal Hospitals in Chorzów.
– The pain of childbirth is unfortunately compared to a serious injury. In the old days, operations were also performed without anesthesia and some patients survived – says Professor Mirosław Czuczwar, head of the Department of Anaesthesiology and Intensive Therapy at the Independent Public Clinical Hospital No. 1 in Lublin.
Not every woman will want anesthesia, some will have contraindications to it. But every woman should have access to it. – The National Health Fund finances such a procedure – assures Marta Żbikowska-Cieśla, the Wielkopolska provincial branch of the National Health Fund. – We have access in law, but zero in implementation – adds Monika Piekarek, “Rodzić po Ludzku” Foundation.
Nationally, the percentage of anesthesia is 14 percent. There are provinces where it is higher. But mostly a few percent of women get anesthesia. Two in Zachodniopomorskie and Lubelskie, one percent in Kujawsko-Pomorskie and less than one percent in Wielkopolska, where in 2022, out of nearly seventeen thousand deliveries, 39 women received epidural anesthesia. – If we (the patient – editor’s note) refuse (anesthesia – editor’s note), she will give birth anyway, because this is the order of things. And this birth will be a trauma, a terrible experience for her – explains Professor Marzena Dębska, specialist in gynecology, obstetrics and perinatology from the “Dębski Clinic” medical clinic.
In addition to the epidural, there are other methods – drugs, massage and laughing gas. “Unfortunately, they cannot be compared to epidural anesthesia in terms of effectiveness and safety,” admits Professor Czuczwar.
Anesthesia is not given to women in small district hospitals and in large provincial centers where the largest number of children are born – as in Toruń. – Unfortunately, there is this problem with the availability of anesthesiologists throughout Poland. Therefore, we can offer this anesthesia when an anesthesiologist is available – explains Professor Małgorzata Świątkowska-Freund from the Department of Obstetrics, Gynecology and Oncological Gynecology of the Wojewódzki Szpital Zespolony im. L. Rydygier in Toruń. In this facility, the anesthesiologist must not have been available even once, because in 2022 not a single epidural was performed there.
The lack of anesthesiologists is not the only problem. There must also be trained staff, a doctor convinced to anesthesia and management who will find a way to get the price too low. This was achieved in Chorzów, the hospital with the second best percentage of anesthesia in the country. – You can’t make money on this with these realities of the National Health Fund. This is the decision of the hospital management, far-sighted, marked by standards – admits Zbigniew Swoboda.
Main photo source: TVN facts