While you're in labor, your doctor, midwife, or nurse should ask if you need pain relief. It is her job to help you decide what option is best for you. Nowadays women in labor have many pain reliefs options that work well and pose small risks when given by a trained and experienced doctor. Doctors also can use different methods for pain relief at different stages of labor. Still, not all options are available at every hospital and birthing center. Plus, your health history, allergies, and any problems with your pregnancy will make some methods better than others.
Methods of relieving pain commonly used for labor are described in the chart below. Keep in mind that rare, but serious complications sometimes occur. Also, most medicines used to manage pain during labor pass freely into the placenta. Ask your doctor how pain relief methods might affect your baby or your ability to breastfeed after delivery.
||How it can help
|Opioids – also called narcotics, are medicines given through a tube inserted in a vein or by injecting the medicine into a muscle. Sometimes, opioids also are given with epidural or spinal blocks.
||Opioids can make the pain bearable, and don't affect your ability to push. After getting this kind of pain relief, you can still get an epidural or spinal block later.
||• Opioids don't get rid of all the pain, and they are short-acting.
• They can make you feel sleepy and drowsy.
• They can cause nausea and vomiting.
• They can make you feel very itchy.
• Opioids cannot be given right before delivery because they may slow the baby's breathing and heart rate at birth.
|Epidural and spinal blocks – An epidural involves placing a tube (catheter) into the lower back, into a small space below the spinal cord. Small doses of medicine can be given through the tube as needed throughout labor. With a spinal block, a small dose of medicine is given as a shot into the spinal fluid in the lower back. Spinal blocks usually are given only once during labor.
||Epidural and spinal blocks allow most women to be awake and alert with very little pain during labor and childbirth. With an epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness you feel can be adjusted throughout your labor. With a spinal block, good pain relief starts right away, but it only lasts 1 to 2 hours.
||• Although you can move, you might not be able to walk if the medicine used affects motor function.
• It can lower your blood pressure, which can slow your baby's heartbeat. Fluids given through IV are given to lower this risk. Fluids can make you shiver. But women in labor often shiver with or without epidural.
• If the covering of the spinal chord is punctured, you can get a bad headache. Treatment can help the headache.
• Backache for a few days after labor.
• Epidural can prolong the first and second stages of labor. If given late in labor or if too much medicine is used, it might be hard to push when the time comes. Studies show that epidural increases the risk of assisted vaginal delivery.
|Pudendal block – A doctor injects numbing medicine into the vagina and the nearby pudendal nerve. This nerve carries sensation to the lower part of your vagina and vulva.
||This is only used late in labor, usually right before the baby's head comes out. With a pudendal block, you have some pain relief but remain awake, alert, and able to push the baby out.
||• The baby is not affected by this medicine and it has very few disadvantages.