Delivery: Pain Management

Pain during labor serves a purpose.  It triggers the release of:

• Oxytocin, which strengthens contractions, helps labor progress, and creates a sense of well-being.
• Endorphins, your body's natural pain relievers, which support you during and after birth.

While labor pain can be intense, it won’t last forever.  It also signals your baby is on the way.

There are also many safe and effective pain relief options that can keep you comfortable without interfering with labor or affecting your baby.

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An epidural is administered through a small catheter in the lower back and is used to block pain.  A combined spinal-epidural block provides faster relief and may use a lower dose of medication.

Pros:

• Provide strong pain relief, allowing you to rest during labor.
• Can be adjusted to keep you comfortable as labor progresses.
• Allow you to remain awake and alert, though you'll still feel pressure and some stretching during delivery.
• Little to no effect on your baby.

Cons:

• Generally not given in the late stages of labor, especially if you're close to pushing.
• May cause your blood pressure to drop.
• Possible side effects include fever, itchiness, back soreness, and, rarely, a severe headache.

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Narcotics reduce pain without completely blocking sensation and are typically given to you through an IV.

Pros:

• Work quickly, usually within minutes.
• Short-lasting, so they can be used at different stages of labor.
• May have a relaxing effect.

Cons:

• Don't provide as much pain relief as an epidural.
• Can cause nausea, vomiting, or drowsiness.
• May affect your baby's breathing or interfere with early breastfeeding if given too close to delivery.

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Nitrous oxide, which is given through a mouthpiece or face mask, can also help with pain.

Pros:

• You can control how much medication you receive.
• Wears off quickly once the mask is removed.
• Little to no effect on your baby.

Cons:

• Not as effective as an epidural.
• Cannot be used with IV narcotics.
• Can cause nausea, dizziness, or drowsiness.

Though not very common, general anesthesia (being "put to sleep") may be used for cesarean deliveries in an emergency or if an epidural or spinal anesthesia isn't working.

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You can also manage pain naturally with these techniques:

• Move or change positions.  Sway, squat, get on your hands and knees, use a birth ball, walk, or lie on your side.
• Practice deep breathing, counting, chanting, or panting.
• Use massage or touch.  Try shoulder rubs, counterpressure, palm pressure, acupressure, or a hip squeeze.

Choosing a natural technique may give you more privacy during labor.

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