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Labor and Pain Relief

Is labor pain the same for all women?
What are the types of pain relief for labor pain?
What are systemic analgesics?
What is local anesthesia?
What is regional analgesia?
What are the different types of regional analgesia…
What are the side effects and risks of regional analgesia?
What is general anesthesia?
Are there risks with the use of general anesthesia?
What type of anesthesia is used for cesarean births?

Is labor pain the same for all women?

  • The amount of pain a woman feels during labor may differ from that felt by another woman
  • Pain depends on many factors
    • Fetal size and position
    • Strength of contractions
  • Some women take classes to learn breathing and relaxation techniques
    • This helps cope with pain during childbirth
    • Some use these techniques along with pain medications

What are the types of pain relief for labor pain?

  • There are two types of pain-relieving drugs ? analgesics and anesthetics
  • Analgesia is the relief of pain without total loss of feeling or muscle movement
    • Analgesics do not always stop pain completely but they do lessen it
    • Anesthesia is blockage of all feeling including pain
    • General anesthesia causes you to lose consciousness
    • Local anesthesia removes all feeling of pain from parts of the body while you stay conscious

What are systemic analgesics?

  • Systemic analgesics are often given as injections into a muscle or vein
    • They lessen pain but will not cause you to lose consciousness
    • They act on the whole nervous system rather than a specific area
  • Sometimes other drugs are given with analgesics to relieve the anxiety or nausea that may be caused by these types of pain relief
    • This pain medicine can have side effects:
      • Nausea
      • Feeling drowsy
      • Trouble concentrating
  • Systemic analgesics are not given right before delivery
    • They may slow the baby?s reflexes and breathing at birth

What is local anesthesia?

  • Local anesthesia provides numbness or loss of sensation in a small area
    • It does not lessen the pain of contractions
  • A procedure called an episiotomy may be done before delivery
    • Local anesthesia is helpful when an episiotomy needs to be done or when any vaginal tears that happened during birth are repaired
    • Local anesthesia rarely affects the baby
    • Generally, no side effects occur after the local anesthetic has worn off

What is regional analgesia?

  • Regional analgesia relieves pain in one region of the body
    • Is the most effective method of pain relief during labor and causes few side effects

What are the different types of regional analgesia…

  • Epidural analgesia, spinal blocks, and combined spinal?epidural blocks are all types of regional analgesia that are used to decrease labor pain:
    • Epidural analgesia
      • Sometimes called an epidural block, this form of analgesia causes some loss of feeling in the lower areas of your body, yet you remain awake and alert
      • The block is given in the lower back into the epidural space below the spinal cord
      • Pain relief begins within 10?20 minutes after the medication has been injected
      • After the epidural needle is placed, a catheter is usually inserted through it, and the needle is withdrawn
      • Small doses of the medication can then be given through the tube
        • Medication can be given continuously without another injection
      • You can move after you have an epidural block, but you may not be allowed to walk around
    • Spinal block
      • A spinal block can be given using a much thinner needle
      • It is injected into the sac of spinal fluid below the level of the spinal cord
      • Spinal block uses a much smaller dose of the drug
      • Once the drug is injected, pain relief occurs right away
      • It lasts only 1?2 hours
      • A spinal block is given only once during labor, so it is best suited for pain relief during delivery
    • Combined spinal epidural block
      • This form has the benefits of both an epidural block and a spinal block
        • The spinal part helps provide pain relief right away
        • Drugs given through the epidural provide pain relief throughout labor
        • This type of pain relief is injected into the spinal fluid and into the space below the spinal cord
        • Some women may be able to walk around after the block is in place.
        • For this reason this method sometimes is called the ?walking epidural.?

What are the side effects and risks of regional analgesia?

  • Although rare, complications or side effects, such as decreased blood pressure or headaches, can occur
    • To help prevent a decrease in blood pressure, fluids will be given through a vein by a tube in the arm
    • Some women may get a headache after having an epidural block
      • A woman can help decrease the risk of a headache by holding as still as possible while the needle is placed
      • If a headache does occur, it often subsides within a few days
      • If the headache does not stop or if it becomes severe, a simple treatment may be needed to help the headache go away
  • The veins located in the epidural space become swollen during pregnancy
    • Because of this, there is a risk that the anesthetic medication could be injected into one of them
      • You may notice dizziness, rapid heartbeat, a funny taste, or numbness around the mouth when the epidural is placed
        • Let your health care provider know right away

What is general anesthesia?

  • General anesthetics are medications that put you to sleep
    • If you have general anesthesia, you are not awake and you feel no pain
      • General anesthesia often is used when regional analgesia is not possible
    • It can be started quickly and causes a rapid loss of consciousness
      • It is often used when an urgent cesarean delivery is needed

Are there risks with the use of general anesthesia?

  • A major risk during general anesthesia is caused by food or liquids in the woman?s stomach
    • Labor usually causes undigested food to stay in the stomach
      • During unconsciousness, this food could come back into the mouth and go into the lungs
        • You may be told not to eat or drink once labor has started
    • If you need general anesthesia, your anesthesiologist will place a breathing tube into your mouth and windpipe after you are asleep
    • If you are having a cesarean delivery, you also will be given an antacid to reduce stomach acid
      • In some cases, ice chips or small sips of water are allowed during labor
      • Talk to your health care provider about what is best for you

What type of anesthesia is used for cesarean births?

  • If you already have an epidural catheter in, stronger medications may be injected
    • Usually for cesarean delivery or vaginal birth that requires forceps or vacuum extraction
    • Spinal anesthesia can also be used
  • Whether you have general anesthesia or regional anesthesia for a cesarean birth will depend on your health and that of your baby
    • It also depends on why the cesarean delivery is being done
    • In emergencies or when bleeding occurs, general anesthesia may be needed

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