Labor and Pain Relief

Is labor pain the same for all women?

Labor pains may not always be the same for every woman. Labor pains depend on the size and position of the fetus. There are classes available to learn breathing and relaxation techniques to cope with labor pains.

What are the types of pain relief for labor pain?

Analgesics and anesthetics are the two types of medications used to relieve pain.

Analgesia relieves pain without total loss of feeling or muscle movement.
Anesthesia blocks all feeling including pain.
General anesthesia causes the loss of consciousness.
Local anesthesia removes feeling from a specific part of the body, allowing you to stay awake.

What are systemic analgesics?

Systemic analgesics lessen pain but do not cause you to lose consciousness. Systemic analgesics are usually given through a shot or an IV line.

Sometimes this pain medication has side effects:

Drowsiness
Nausea
Trouble concentrating

Systemic analgesics are not given right before delivery because they may slow the baby’s reflexes and breathing.

What is local anesthesia?

Local anesthesia numbs a small area but does not lessen the pain of contractions. Local anesthesia is helpful when an episiotomy needs to be done or if there is any vaginal tears that need to be repaired. Local anesthesia rarely harms the baby and has no side effects.

What is regional analgesia?

Regional analgesia relieves pain in a certain region of the body. Regional analgesia causes few side effects and is the most effective method of pain relief for labor.

What are the different types of regional analgesia?

The different types of regional analgesia are:

Epidural analgesia (sometimes called an epidural block) causes some loss of feeling in the lower regions of your body and allows you to remain awake. The epidural block is injected in the lower back into the epidural space below the spinal cord, and pain relief will begin within 10-20 minutes. Usually, a catheter is inserted through the needle, and small doses of analgesia can be given through the tube continuously throughout labor.
A spinal block is injected into the sac of spinal fluid below the spinal fluid, and is can be given through a much smaller needle than an epidural. Pain relief will occur right away, but only lasts 12 hours. A spinal block is only given once during labor, so it is best for pain relief during delivery.
A combined spinal epidural block contains the benefits from both the spinal and the epidural block. Pain relief will occur right away. Pain relief will be provided throughout labor (can be given continuously because of the epidural). It is injected into the spinal fluid and into the space below the spinal cord. It is sometimes called the walking epidural because some women may be able to walk around after the block is in place.

What are the side effects and risks of regional analgesia?

Side effects with regional analgesia are rare, but decreased blood pressure or headaches can sometimes occur. To prevent decreased blood pressure, fluids will sometimes be given through an IV tube. Hold as still as possible while the needle is placed during an epidural block to help prevent headaches. Headaches should subside within a few days, but if not, treatment may be needed. There is a risk of anesthetic medicine being injected into a vein in the epidural space because they sometimes become swollen during pregnancy.

If this happens, you may notice:

Rapid heartbeat
Dizziness
Funny taste
Numbness around the mouth.

Let your health care provider know right away if you experience this.

What is general anesthesia?

General anesthesia are medications that put you to sleep and cause you to not feel any pain because you are unconscious. General anesthesia is often used when urgent cesarean delivery is needed.

Are there risks with use of general anesthesia?

One of the major risks with general anesthesia is caused by the food or liquids in the woman’s stomach. During labor, undigested food usually stays in the stomach. While unconscious under general anesthesia, this food could come back up into the mouth and go into the lungs. Once labor has started, you may be told not to eat or drink anything.

If general anesthesia is required, your anesthesiologist will place a breathing tube into your mouth and windpipe after you are asleep. You will also be given antacids to reduce stomach acid if you are having a cesarean delivery.

What type of anesthesia is used for cesarean births?

If you already have an epidural catheter in, stronger medications will be injected into the tube.
Spinal anesthesia may also be used.
It will depend on your health and your baby’s health whether you receive general anesthesia or regional anesthesia for a cesarean delivery.
General anesthesia is typically used for emergencies or when bleeding occurs.

Labor and Pain Relief