Pain Relief During Labor

There are two big questions women may ponder as their due date nears: "How much will labor hurt?" and "What can I do about it?" Each birth---and each woman's response to it---is unique. Different types of pain relief are available during childbirth. You should have an idea of what you prefer, but it is often best to keep your options open. There are things that happen during labor that may surprise you or your doctor. The well-being of you and your baby is the main issue to keep in mind.

Certain methods provide pain relief from labor right through delivery. Others are used when you are pushing the baby out or during cesarean birth.

What Affects Your Feelings of Pain?

  1. Fear of the unknown. Learn as much about childbirth as you can before delivery. Read about it, attend childbirth classes, or ask your doctor. The more you know about the process, the less scary it will be to you.
  2. Feeling helpless. Learn ahead of time what your options are for labor and delivery. Practice the pain management methods taught in childbirth classes.
  3. Fear of losing control. Some women fear losing their cool as well as losing control of their body. Keep in mind that your body knows what to do, even if you don't. Do what your body tells you to do, and don't worry about making a fool of yourself.
  4. Being alone. It's vital to have the support of your partner or a loved one during labor and delivery. The hands-on attention of the labor and delivery nurse or doula will greatly enhance the delivery process.
  5. Fatigue. Rest as much as you can during early labor. As labor wears on, rest after each contraction so you can cope with the next one.
  6. Anxiety and tension. Focus on your breathing during contractions. Use relaxation techniques between them.
  7. Expecting and fearing a lot of pain. Don't focus on how much contractions hurt. Instead, try to distract yourself by using a focal point or doing breathing exercises. Remind yourself that each contraction is bringing you closer to your new baby. If you feel scared, go ahead and say so. Airing your fears givers others a chance to comfort you.

What is an Epidural Block?

Epidural block is an anesthetic that removes all feeling from the lower half of your body. An epidural numbs the pain of contractions. It can also numb the vagina as the baby is pushed out. In larger doses, an epidural controls pain during a cesarean birth.


What Happens When Given an Epidural?

  1. Your back is washed with an antiseptic.
  2. A small area of skin is numbed with a local anesthetic.
  3. You will be asked to sit or lie on your side and asked to curve your back outwards. You will need to stay in this position until the injection is over.
  4. An anesthesiologist will then insert a needle into your lower back. The needle will be placed in the epidural space near your spine. This is where the nerves carry signals from the lower body to the spinal cord.
  5. After the needle is in place, a catheter is inserted through it and the needle is withdrawn. The catheter is left in the epidural space so the anesthetic agents can be injected during labor and delivery to control the pain sensations of labor.
  6. You can move around after the epidural is given, however, you won't be able to walk.

Drawbacks

  1. An epidural will cause your blood pressure to drop and, in-turn, cause your baby's heartbeat to drop as well. To prevent this, you'll be given I.V. fluids through your I.V. before the drug is injected. You may also need to lie down on your side to improve the blood flow.
  2. After delivery, your back may be sore from the injection.
  3. If the covering of the spinal cord is pierced, you can get a bad headache. If it's not treated, this headache can last for days. This complication is rare.
  4. If an epidural is given too early (before 4-5 centimeters dilated), it usually slows labor down. In this case, I.V. medication may be given to restart the labor pattern.
  5. An epidural also causes you to miss the sensation of pushing the baby out. If you can't feel what you are doing, you won't push as well as you could.
  6. Although it rarely happens, if the drug given enters a vein it can cause dizziness or seizure.

Systemic Analgesia

Systemic analgesia acts on the whole nervous system, rather than on just one area. These medications are injected into a muscle or into your I.V. site for immediate pain relief. This lessens the pain, but will let you stay awake. Sometimes other drugs are given with the systemic analgesics to relieve tension or nausea. Like other medication analgesia can have side effects, which may include feeling drowsy, nauseous, or trouble focusing. However, serious side effects are rare.


Pain Relief During Birth

Local Anesthesia

Just as your dentist uses medication to numb your mouth before filling cavities your doctor can use local anesthesia during delivery. Local anesthetics numb a small area and are injected into the skin or muscles involved in childbirth. Local anesthesia does not affect the baby or labor.


Pudendal Block

This is an anesthetic that's injected through the vaginal walls shortly before delivery to block pain at delivery.


Paracervical Block

This is an injection of a local anesthetic at the dilating cervix, thus blocking pain. It can be used instead of an epidural or I.V. analgesics.


General Anesthesia

There are rare circumstances when a general anesthetic will be used. It is mostly used in cases of emergency.