Pain Relief During Labor

You may want to start thinking about whether you would like pain relief during labor and delivery. You don’t have to decide now, but it’s a good idea to know your options. Even if you do make a decision now, you may change your mind once you’re in labor.

Each woman’s labor is unique. The amount of pain a woman feels during labor may differ from that felt by another woman. Pain depends on many factors, such as the size and position of the baby, the strength of contractions, and how you handle pain.

Some women take classes to learn breathing and relaxation techniques to help cope with pain during childbirth. Others may find it helpful to use these techniques along with pain medications.

There are two types of pain-relieving drugs — analgesics and anesthetics. Analgesics lessen the pain, while anesthetics block all pain and sensation. Some forms of analgesics used in labor are: morphine, fentanyl, and nitrous oxide. Different analgesics are able to be used during different stages of labor:

  • Morphine: Sometimes used in early labor and is given through an intramuscular injection. It helps dull the pain for about 4 hours. It can cause nausea and is given with an anti-nausea medication, phenergan, to alleviate this possible side effect. Before and with this medication the baby’s heart rate is monitored.
  • Fentanyl: Sometimes used in early labor or active labor, but not given close to delivery and is given through an IV. It helps dull the pain for about 30 to 60 minutes. Before and with this medication the baby’s heart rate is monitored.
  • Nitrous Oxide(laughing gas): Can be used during any stage of labor during the peak of a contraction. The mother holds a face mask and breathes in needed amount. Again, this dulls the pain but doesn’t fully eliminate the pain.

Some forms of anesthesia, such as general anesthesia, cause you to lose consciousness. General anesthesia usually is not used for vaginal births. Other forms, such as regional anesthesia, remove all feeling of pain from parts of the body while you stay conscious. Several forms of regional anesthesia are used during childbirth:

  • Epidural Block: Epidural blocks cause loss of some feeling in the lower part of a woman’s body, yet she remains awake and alert. An epidural block may be given soon after contractions start or later as labor progresses. It is given through a thin tube inserted in the lower back.
  • Spinal Block: A spinal block — like an epidural block — is done with an injection in the lower back. It provides good relief from pain and starts working fast, but it lasts only an hour or two. It usually is used for cesarean delivery and only rarely in late labor or for a vaginal delivery.
  • Combined Epidural-Spinal Block: A combined spinal–epidural block has the benefits of both types of pain relief. The spinal part helps provide pain relief right away. Drugs given through the epidural provide pain relief throughout labor.

There are advantages and disadvantages for each form of analgesia and anesthesia. An anesthesiologist will work with your health care team to help you choose the best method.