Pain Relief in Labor and Delivery

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KEY POINTS

• There are many ways to lessen pain during labor and the birth of a baby.
• You may be given narcotic pain medicines or sedatives during labor, but usually not during birth. You may have regional anesthesia, which numbs part of your body while you stay awake. If you have a difficult delivery or a C-section, you may have general anesthesia, which relaxes your muscles and puts you into a deep sleep.
• Instead of medicines, some women use the Lamaze or Bradley methods, hypnosis, or acupuncture to cope with labor pain. These techniques can also be used with other treatments for labor pain.
• Talk with your healthcare provider about ways to relieve pain during prenatal visits.

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What types of pain relief might be used?

There are many ways to lessen pain during labor and the birth of a baby.

Narcotics and sedatives

Narcotics are a type of pain medicine. Sedatives are drugs used to relieve anxiety and help you relax. These medicines may be used during the first stage of labor to help you relax. They are usually not used when your baby is about to be delivered.

When sedatives are given with a narcotic, they help the narcotic lessen the pain by helping you feel less tense or anxious. Because narcotics and sedatives affect all of your body, both you and your baby may have side effects from these drugs.

• You may feel sleepy or dizzy.
• You may have trouble thinking and it may be harder for you to push during delivery.
• Your breathing or heart rate may slow down.
• The baby’s reflexes and heart rate may slow down. The baby may breathe too slowly at birth.

To lessen the chance of serious problems, narcotics and sedatives are given in small doses.

Regional anesthesia

Regional anesthesia lessens or completely blocks the pain in a specific part of the body. One type of regional anesthesia is called an epidural block. The medicine is given through your lower back to numb the birth canal and the area around the baby during labor and delivery. It eases the pain, but you may still feel your contractions. In higher doses, an epidural may be used to deliver the baby surgically with a C-section.

Other types of blocks are sometimes used to relieve pain. For example, an anesthetic may be injected inside the vagina just before delivery to relieve pain around the vagina and rectum as the baby comes down the birth canal. This is helpful before an episiotomy, which is a small cut made by your provider to make the birth canal opening bigger.

Most kinds of regional anesthesia are less likely to affect the baby because the medicine does not get into your bloodstream. However, an epidural block may lower your blood pressure or cause a fever. This may slow the baby's heartbeat. To help prevent this, you will be given a lot of fluids through an IV before you are given the block. After an epidural, you will also need to lie on your left side to take the pressure off the large blood vessels in your pelvis and back.

Other possible side effects are trouble breathing, headache, and longer labor. Regional anesthesia can make it harder for you to push and help deliver the baby. The baby's head may not turn normally during delivery.

General anesthesia

General anesthesia relaxes your muscles and puts you into a deep sleep. It may be needed for a difficult vaginal delivery. For example, it may be needed if you are bleeding too much or the baby is having problems and you need a quick delivery. It may also be used for a C-section.

Pain relief without drugs

Some ways to cope with labor pain without drugs are:

• Lamaze or Bradley methods of childbirth preparation: You and your partner can take classes to learn about childbirth, body-conditioning exercises, and ways to relax. Breathing exercises are an important part of the Lamaze method. Using meditation is the focus in the Bradley method. Many mothers who use these methods are able to go through childbirth with less pain medicine or none at all.
• Hypnosis: Hypnosis requires a lot of time and classes with an expert in hypnosis before you are ready for delivery.
• Acupuncture: Small needles are put in specific parts of the body to lessen the pain of contractions.
• Transcutaneous electrical nerve stimulation (TENS): Mild electric impulses are used to stimulate the nerves and block pain.

All of these techniques can be used with other treatments for labor pain.

What type of pain relief is right for me?

The type of pain relief that is right for you depends on:

• Your physical condition during labor
• Your training for childbirth
• The length of your labor
• The amount of labor pain
• The condition of your baby during labor

During prenatal visits talk with your healthcare provider about ways to relieve pain. Also discuss any fears you have about labor and delivery.