Pain Management Options in Labor & Delivery
If you're like most women, the pain of labor and delivery is not something to which you are looking forward to. Though some women do experience little pain during labor, they are a minority. Most women experience labor as a painful process. For this reason, it is important to educate yourself about your options for pain management during labor, and to decide which methods will best fit your needs. Keep in mind that your best bet is to be well informed and flexible in your options because you won’t know how painful labor will be until you actually experience it. Work with your midwife or doctor to decide which types of pain relief you are interested in, so that there is no confusion once you are in labor! Generally, mothers and their providers want to use the safest and most effective method of pain relief for both mother and baby.
There are three main types of pain management for labor and birth:
Natural Labor or Non-Medicated Measures
Analgesics (IV pain medication or a shot)
Anesthesia (epidural)
Natural labor
Lamaze teaches that birth is a normal, natural, and healthy process and that a woman should be empowered to approach it with confidence. Lamaze teaches women ways to decrease their perception of pain, such as through relaxation techniques, breathing exercises, distraction, or massage by a supportive coach.
Breathing techniques help by calming and relaxing you as labor contractions intensify. Childbirth classes can help you harness the power of breathing to help you through your contractions. There are many methods of patterned breathing techniques that can be very effective in labor.
Focusing on something other than contractions helps women cope with labor. Some women prefer an internal focus. They visualize their bodies working for them, or mentally “remove” themselves to a pleasant and peaceful place. Others prefer an external focus. Concentration on an object or a face, listening to music, or movement such as swaying or massage helps many women cope.
Relaxation is one of the most important skills you can learn to reduce the pain and discomfort of labor. When under stress, most people are unaware of how tense their necks, shoulders, arms, etc., really are. The less your body has to “work” in these areas, the more progress it can make during each contraction. Although you won’t have a lot of time between contractions, you should try to rest and relax as much as possible between each one.
Analgesics
Analgesics (systemic painkillers) are medications to relieve pain such as Fentanyl, Stadol, Morphine, Demerol, and Nubain. These narcotics dull the pain but do not completely eliminate it. They are either delivered into the bloodstream through an IV or injected into a muscle, and they affect your entire body rather than concentrating pain relief in the uterus and pelvic area. You may feel sleepy and/or light headed after receiving IV pain medication. The smallest dose possible is given because of the potential adverse effects of these drugs on the fetus. These drugs easily cross the placenta to the fetus and may take a long time to clear from the baby’s system even after birth. Analgesics can cause respiratory depression in the baby and for this reason; analgesics are not given to the mother an hour or two before the birth.
Anesthesia
Epidural: The basics behind an epidural are that it can greatly reduce or eliminate the pain of labor and delivery. It is a form of continuous pain relief to the lower part of your body while allowing you to remain fully conscious. Medication is delivered through a small catheter (or tube) that is inserted into the epidural space just outside the membrane that surrounds your spine. The catheter is inserted through a needle into your back after your back has been numbed. The medications used in an epidural are usually a combination of local anesthetic and narcotics. The medication is controlled by a pump that infuses continuously and is set up by the anesthesiologist.
