Pregnancy Info

Pain management during labor and delivery can make a huge difference in your birthing experience. Get info on birthing techniques, pain management options, epidurals, and more. Find tips for choosing the right type of pain management for you and your baby.

Almost all women feel some pain during labor and delivery, and the fear of that pain can be a source of anxiety for pregnant women when looking forward to the big day. Learning about pain management during labor and delivery, and being flexible about the options, can help prepare pregnant women who are getting ready for labor and delivery.

Most of the pain during labor comes from the contractions of the uterus, pressure from the baby, and the stretching of the birth canal. Women experience these pains differently, even from one pregnancy to the next. For first time mothers the pain may seem worse, especially because they're not sure what to expect and may feel anxious. Thus pain management during labor and delivery is especially important for first time mothers.

There are two general ways to manage pain during childbirth. One is to use relaxation or other techniques to work through the pain of childbirth. The other is to take medications to help lessen or block the pain. Many women use both methods at different points in their labor and delivery process.

Some of the techniques that may be used for pain management during labor and delivery include:

• Breathing exercises
• Relaxation techniques like focusing on an object or pictures, counting, or imaging something calming
• Taking a shower or bath or labor in a hospital Jacuzzi if one is available and with the doctor's permission
• Having your labor coach massage your back
• Using heat or ice packs on your back
• Trying different labor positions
• Hypnobirthing
• Reflexology
• Acupuncture

It is also helpful to prepare for childbirth by practicing good health habits during pregnancy. This means eating a healthy diet and, if allowed by your doctor, engaging in mild pregnancy exercise. Learning about what to expect during delivery, such as by taking a childbirth class, reading educational materials, or talking to your doctor, also may be helpful for reducing anxiety.

There are several types of pain medications available for pain management during labor and delivery. They generally fall into the categories of analgesics or anesthesias. Analgesics dull pain without making you unconscious, while anesthesias temporarily block all feelings and movement in certain areas or over the whole body.

Systemic analgesics are injections of pain medication into a muscle or vein that affects the whole body. They cause you to feel much less pain. The most common side effects are nausea and feeling drowsy or unfocused. They cannot be given close to delivery or they may cause the baby's breathing or reflexes to be slowed.

Regional analgesics, like epidurals and spinal blocks, dull the feeling below the site where they are given. An epidural is injected into the lower back near the spine, and requires the woman to have a small tube in her back during the labor process. It takes several minutes to start working. Usually you will not be allowed to walk around with an epidural, and you may need to have your bladder drained with a catheter. An epidural carries a small risk of decreased blood pressure, lasting headache, or, rarely, the drug causes more serious problems like difficulty breathing or seizures. This is very uncommon. A spinal block is similar to an epidural, but a drug is injected into the spinal fluid instead.

Anesthesia stops you from feeling any pain in the area where it given, and also makes it so you can't move your body temporarily. Local anesthesias are used for episiotomies and to stitch up tears after delivery. General anesthesias may be used to put someone out completely if there is an emergency during labor. For a C-section delivery, anesthesia can also be given like a spinal block to block all pain below the injection site but allow the woman to remain conscious.

In some cases, women may also be given narcotics or tranquilizers to help with pain management during labor.

The options for pain management available to women vary by location. Pain management techniques may be taught in classes, though which methods are taught depends on what teachers are available in the area and what experience they have. Also, hospitals may only offer certain types of pain medications. In addition, certain medical conditions or emergencies may require women to use a certain type of pain medication, or limit the types of pain management techniques they may use. Women should talk to their doctors about the types of pain management options available to them.

When creating a labor plan or choosing what types of pain management during labor and delivery that you want to use, talk to your doctor about your options, and consider asking:

• How does the pain management work? Does it block or dull pain, or just allow me to deal with the pain?
• How fast does it work?
• What are the possible side effects for myself and my baby?
• When can it be used in the labor and delivery process?
• Can it be used with other pain management techniques?
• How might it affect my labor and delivery?
• How soon can I breastfeed my baby after delivery if I use this method?

Some expectant mothers come to think of childbirth as a test to see if they can make it through without using any pain medications, which can lead to feelings of guilt or failure if a situation arises that requires them to use pain medicine. Using pain medications is not a sign of failure, nor does it mean a woman will be a bad mother. In fact, for some women pain medications help them to focus on their childbirth experience and have an easier time with delivery. Each woman must decide for herself what the best way is to deal with the pain of labor and delivery, and consider the pain management options most likely to lead to a healthy outcome for herself and her baby.

Sources:

American Congress of Obstetricians and Gynecologists, "Pain Relief During Labor and Delivery" [online]
MayoClinic, ""Labor pain: weigh your options for relief" [online]
March of Dimes, Pregnancy and Newborn Health Education Center, "Coping with Labor Pain" [online]
Nemours, KidsHealth, "Dealing with Pain During Childbirth" [online]