Pain Relief During Labor and Delivery
Everyone experiences pain differently, but labor causes severe pain for many women. The amount of pain you experience during labor and delivery depends on your pain tolerance, contraction strength, and your baby's size and position. There are many ways to prepare and deal with the pain, including:
Taking prenatal classes to learn about labor and delivery. The more informed you are, the less anxious and afraid you may be. This can help lessen the pain.
Taking pain-relieving medicine during labor and delivery.
Learning breathing and relaxation techniques.
Taking a shower or bath, getting massaged, changing positions, or placing an ice pack on your back are other options to help control your pain during labor.
Discuss your pain control options with your health care provider during your prenatal visits.
WHAT ARE THE TWO TYPES OF PAIN-RELIEVING MEDICINES?
Analgesics—These are medicines that decrease pain without total loss of feeling or muscle movement.
Anesthetics—These are medicines that block all feeling, including pain.
There can be minor side effects of both types, such as nausea, trouble concentrating, becoming sleepy, and lowering the heart rate of the baby. However, health care providers are careful to give doses that will not seriously affect the baby.
WHAT ARE THE SPECIFIC TYPES OF ANALGESICS AND ANESTHETICS?
Systemic pain medicines affect your whole body rather than focusing pain relief on the area of your body experiencing pain. This type of medicine is given either through an IV tube in your vein or by a shot (injection) into your muscle. This medicine will lessen your pain but will not stop it completely. It may also make you sleepy, but it will not make you lose consciousness.
Local anesthetic is used to numb a small area of your body. The medicine is injected into the area of nerves that carry feeling to the vagina, vulva, or the area between the vagina and anus (perineum).
This type of medicine causes you to lose consciousness so you do not feel pain. It is usually used only in emergency situations during labor. It is given through an IV tube or face mask.
A paracervical block is a form of local anesthesia given during labor by injecting numbing medicine into the right and left sides of the cervix and vagina. It helps to lessen the pain caused by contractions and stretching of the cervix. It may have to be given more than once.
A pudendal block is another form of local anesthesia. It is used to relieve the pain associated with pushing or stretching of the perineum at the time of delivery. An injection is given deep through the vaginal wall into the pudendal nerve in the pelvis, numbing the perineum.
An epidural is an injection of numbing medicine given in the lower back and into the epidural space near your spinal cord. The epidural numbs the lower half of your body. You may be able to move your legs, but not allowed to walk. Epidurals can be used for labor, delivery, or cesarean deliveries.
To prevent the medicine from wearing off, a small tube (catheter) may be threaded into the epidural space and taped in place to prevent it from slipping out. Medicine can then be given continuously in small doses through the tube until you deliver.
A spinal block is similar to an epidural, but the medicine is injected into the spinal fluid, not the epidural space. A spinal block is only given once. It starts to relieve pain quickly but lasts only 1–2 hours. Spinal blocks can also be used for cesarean deliveries.
Combined Spinal-Epidural Block
Combined spinal-epidural blocks combine the benefits of both the spinal and epidural blocks. The spinal part acts quickly to relieve pain and the epidural provides continuous pain relief.
Immersion in warm water during labor may provide comfort and relaxation. It may also help to lessen pain, the use of anesthesia, and the length of labor. However, immersion in water during the delivery (water birth) may have some risk involved and studies to determine safety and risks are ongoing. If you are a healthy woman who is expecting an uncomplicated birth, talk with your health care provider to see if water birth is an option for you.