How Will You Handle Your Labor Pain?

If you’re concerned about the pain that may come with labor and delivery, you’re not alone. You’ve probably heard equally as many “hospital horror stories” as “easier than expected” ones. In truth, women experience and tolerate pain differently. For some pregnant women, focused breathing is all they need to get through labor and childbirth; others need the relief that painkillers can provide.

There are a number of different medications a woman can take during labor and childbirth. It is important to discuss them with your health care provider before your "birth day."

Keep in mind that your pain relief choices may be governed by certain circumstances of your labor and delivery. Throughout your labor, your health care provider will assess your progress and how you are feeling in order to help you choose a pain relief technique.

Getting pain relief should not cause you to feel inadequate. You are the only one who knows how you feel, so decisions regarding control of your labor pain must be made specifically by you. Also, don't worry about the safety of the medicine. All medications provided during childbirth are considered safe for both you and your baby.

What Pain Relief Medications Are Available for Labor and Childbirth?

There are three main ways to provide pain relief during labor and childbirth:

  • Local anesthesia may be used by your health care provider during delivery to numb a painful area in or around the vagina if stitches are needed. Local medications do not reduce discomfort during labor.
  • Regional anesthesia (also called an epidural or spinal anesthesia) is administered by an anesthesiologist (a doctor who delivers pain medicine) during labor to reduce discomfort. In both epidural and spinal anesthesia, medications are placed near the nerves in your lower back to "block" pain in a wide region of your body while you stay awake. Regional anesthesia greatly reduces pain throughout the birthing process. It can also be used if a cesarean birth becomes necessary.
  • General anesthesia puts you to sleep during the birthing process. While safe, general anesthesia is rarely used and only during emergencies because it prevents you from seeing your child immediately after birth.

Pain relieving medications can be injected into a vein or a muscle to dull labor discomfort. These medications do not completely stop pain, but they do lessen it. Because they affect your entire body and may make both you and your baby sleepy, these drugs are mainly used during early labor to help you rest and conserve your energy.

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What Is the Difference Between an Epidural and Spinal Anesthesia?

With a spinal, the medication is injected inside the dura, the tough coating surrounding the brain and spinal cord. During an epidural, medication is put inside the spinal column just outside the sac that surrounds the spinal cord.

A spinal requires less medicine and works faster than an epidural. But it is more likely to cause a headache or low blood pressure.

How Is Regional Anesthesia Given During Labor and Childbirth?

If you request regional anesthesia, you may receive epidural or spinal anesthesia or a combination of the two. Your health care provider will select the type based on your general health and the progress of your labor.

After reviewing your medical history, the anesthesiologist will numb an area on your lower back with a local anesthetic. The anesthesiologist will then insert a special needle into the numb area to find the exact location to inject the anesthetic medication. After injecting the medication, the anesthesiologist will remove the needle. In most cases, a tiny plastic tube called an epidural catheter stays in place after the needle is removed to deliver medications as needed throughout labor.

The procedure can be done while you are either sitting up or lying on your side.

How Soon Can I Get Regional Anesthesia During Labor?

The best time to administer regional anesthesia varies depending on you and your baby's response to labor. Your health care provider will determine the best time for you to receive it.

Will the Anesthesia Affect My Baby?

Research has shown that regional anesthesia -- both epidural and spinal -- is safe for you and your baby.

How Long Does It Take for Anesthesia to Work, and How Long Will It Last?

An epidural starts working 10 to 20 minutes after the medication has been injected. Pain relief from epidural anesthesia lasts as long as you need it because medication can always be given through the catheter.

Spinal anesthesia starts working immediately after the medication has been injected. Pain relief lasts about 2 1/2 hours. If your labor is expected to last beyond this time, an epidural catheter will be inserted to deliver medications to continue your pain relief as long as needed.

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Will I Feel Anything After Getting the Anesthesia?

Although you will feel significant pain relief, you may still feel mild pressure from your contractions. You may also feel pressure when your health care provider examines you.

Will I Have to Stay In Bed After Regional Anesthesia?

Not necessarily. Your anesthesiologist can tailor the anesthesia to allow you to sit in a lounge chair or walk. Walking or sitting may even help your labor. If you are interested, ask your anesthesiologist about a "walking epidural." Keep in mind, however, that your personal situation may not allow it.

Will Regional Anesthesia Slow My Labor?

In some women, labor and contractions may slow for a short period of time after regional anesthesia. Most women find that regional anesthesia helps them to relax and actually improves their contraction pattern while they rest.

If I Have Regional Anesthesia, Will I Be Able to Push?

Yes. Regional anesthesia allows you to rest comfortably while your cervix dilates. It should not affect your ability to push; instead, it will make pushing more comfortable.

Are There Any Side Effects to Regional Anesthesia?

Your anesthesiologist takes special precautions to prevent complications. Although complications are rare, some side effects may include:

  • Lower blood pressure. You will receive intravenous fluids and your blood pressure will be carefully monitored and treated to prevent this from happening.
  • Mild itching during labor. If itching becomes bothersome, your anesthesiologist can treat it.
  • Headache. Drinking fluids and taking pain tablets can help relieve headaches after regional anesthesia. If the headache persists, tell your anesthesiologist and additional medication can be ordered for you.
  • Local anesthetic reaction. While local anesthetic reactions are rare, they can be serious. Be sure to tell your anesthesiologist if you become dizzy or develop ringing in your ears so that he or she can quickly treat the problem.

WebMD Medical Reference Reviewed by Kecia Gaither, MD, MPH on July 20, 2014

Sources

SOURCE: American Pregnancy Association.

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