Best Way to Relieve Pain during Labor and Delivery

In a hospital setting, most pain medications are available. However, your doctor will know which medications are not an option for you because of your medical history or because of where you are in the labor process. Some medications, if given too soon, can slow down or stop your labor.

In a freestanding birthing center, pain relief options include relaxation and breathing techniques, massage, showers, whirlpool, and sometime analgesics. Anesthetics are not available in birthing centers. Many women choose to give birth with a midwife and are successful in delivering their babies without medication.

Some women choose to use a combination of the above comfort measure along with medications. Talk to yourOBprovider about your preferences and remember the goal is to have a healthy baby and a pos­itive birth experience.

Analgesic and Anesthetic Medications

You should become familiar with the different kinds of labor medica­tion and how they will affect you and your baby even if you do not plan to use medications. That way, if medications are requested or become necessary, you’ll know their purpose and effect.

There are two types of medications used in labor and delivery: anal­gesics and anesthetics.

Analgesics, such as Demerol, give you pain relief from the contrac­tions during labor by directly affecting the brain and central nervous system via your blood. They will help you relax between contractions but will not numb any part of your body. They significantly reduce the pain of labor but usually do not take it away completely. Possible side effects include drowsiness and difficulty concentrating. They’re not given just before delivery because they may slow the baby’s reflexes and breathing. This is an excellent choice for short-term pain relief or if you cannot have anesthesia.

Anesthesia (regional or local) affects only the area of the body where it is given. The laboring mother remains awake for the birth of the baby. Administering any kind of anesthesia requires a physi­cian, and this medication can only be given in a hospital. Possi­ble side effects include headaches, backaches, tachycardia (rapid heart rate), a drop in blood pressure, and cessation of labor. If labor stops or slows, you’ll need another medication (Pitocin) to induce labor.

Spinal Block

Spinal anesthesia is very similar to an epidural but is used mainly for cesarean deliveries or for deliveries that seem likely to need a vacuum or forceps extraction. A spinal block:

•  Numbs more of the body, usually from just below the breast down to the feet.
•  Is injected into the lower spine, directly into the spinal fluid, while you’re sitting up.
•  Is usually administered only once, just before the baby is deliv­ered.
•  Will cause a loss of all muscle control, including control of abdominal muscles. It affects your ability to push.
•  Lasts several hours.
•  Has side effects similar to an epidural.

Pudendal Block

A pudendal block numbs only the “birth canal,” or vagina and vulva. It alleviates the discomfort of the delivery, not the labor. A pudendal block:

•  Is administered when the baby is about to enter the birth canal or vagina and be delivered.
•  Is injected near the nerves on the sides of your vagina.
•  Does not provide any relief from the pain of your contractions.
•  Does not interfere with pushing.

•  Usually has no direct effect on your baby. The area will remain numb for the stitching of the tear or episiotomy.
•  Is considered one of the safest forms of anesthesia.
•  Rarely results in serious side effects.

General Anesthesia

General anesthesia is sometimes used for a cesarean birth, but usually for emergency deliveries when the baby needs to be taken out quickly. You may have general anesthesia for a cesarean if you are unable to have spinal or epidural anesthesia. The medication can be given through an IV line or in gas form with a mask, or some­times both.

General anesthesia is usually not performed “electively.” Any kind of surgery that requires anesthesia involves some risk, and so doctors do not use general anesthesia unless it is medically necessary. General anesthesia can affect your baby by slowing its reflexes and breathing and causing sleepiness.