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Labor and Delivery - Managing Pain

You can choose from several types of pain relief for childbirth. These include medicine or breathing techniques, as well as comfort measures. You also can use a combination of these choices.

Comfort measures

There are many ways to reduce the stresses of labor and delivery. "Natural" childbirth techniques (without medicine) may help reduce pain and help you feel a sense of control during labor. Consider:

  • Continuous labor support. Having a support person with you from early labor until after childbirth has a proven, positive effect on childbirth.1
  • Distraction. During early labor, you can walk, play cards, watch TV, take a shower, or listen to music to help take your mind off your contractions.
  • Massage. Massage of the shoulders and lower back during contractions may ease your pain. Strong massage of the back muscles (counterpressure) during contractions may help relieve the pain of back labor. Tell your labor coach exactly where to push and how hard to push.
  • Imagery. Imagery is using your imagination to decrease your pain. For instance, to help manage pain, visualize contractions as waves rolling over you. Picture a peaceful place, such as a beach or mountain stream, to help you relax between contractions.
  • Changing positions during labor. Walking, kneeling, or sitting on a big rubber ball (birth ball) are good options. For more information see Labor Positions.
  • Focused breathing techniques. Breathing in a rhythm can distract you from pain. Childbirth education classes will teach you different methods of focused breathing.
  • Laboring in water. Soaking in warm water may help with pain, stress, and sometimes slow, difficult labor.2, 3

Other techniques without medicine

Other techniques that don't use medicine to control pain include:

  • Hypnosis. This is a low-risk way of managing labor pain and anxiety that works for some women.4
  • Acupuncture. Small studies suggest that acupuncture is a low-risk, effective way of managing labor pain for some women.4

Pain relief with medicine

Your options for pain relief with medicine may include:

  • Opioids (narcotics), which are used to reduce anxiety and partially relieve pain. An opioid is less likely than epidural anesthesia to lead to an assisted (forceps or vacuum) delivery.5 But an opioid is usually not used when you are close to delivery, because it can affect a newborn's breathing.
  • Epidural anesthesia, which is an ongoing injection of pain medicine into the epidural space around the spinal cord. This partially or fully numbs the lower body.
    Pregnancy: Should I Have an Epidural During Childbirth?
  • Pudendal and paracervical blocks. These are injections of pain medicine into the pelvic area to reduce labor pain. Pudendal is one of the safest forms of anesthesia for numbing the area where the baby will come out. It can be helpful with fast labor when a little pain medicine is needed close to delivery.

Some pain-relief medicines aren't the type that you would request during labor. They are used as part of another procedure or for an emergency delivery. But it's a good idea to know about them.

  • Local anesthesia is the injection of numbing pain medicine into the skin. This is done before inserting an epidural or before making an incision (episiotomy) that widens the vaginal opening for the birth.
  • Spinal block is an injection of pain medicine into the spinal fluid. It quickly and fully numbs the pelvic area for assisted births, such as a forceps or cesarean delivery.
  • General anesthesia is the use of inhaled or intravenous (IV) medicine, which makes you unconscious. It has more risks, yet it takes effect much faster than epidural or spinal anesthesia. So general anesthesia is usually only used for some emergency C-sections that require a rapid delivery.
1

WebMD Medical Reference from Healthwise

Last Updated: February 15, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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