Information for Expectant Mothers
Each person's childbirth experience is unique. The amount of pain felt during labor depends on an individual's level of pain tolerance, the size and position of the baby, the strength of uterine contractions and other birth experiences. Sometimes labor goes quickly and easily; sometimes it is painful and exhausting. Many women are able to use breathing exercises and relaxation methods to reduce labor discomfort. The emotional support provided by labor and delivery nurses is also comforting to many. Others want pain relief at the second or third stage of labor and delivery.
Labor can be unpredictable, and some moms may want to know about pain management choices before labor begins. Be sure to ask the clinic doctor, or nurse, questions during your prenatal visits. Moms can also ask the specially trained nurses during Childbirth Preparation classes.
An important point to remember is that everyone experiences pain differently. Only the expectant mom will know the level of pain being experienced, so never feel guilty about asking for pain relief.
General Thoughts on Anesthesia & Pain Medications
When it comes to the use of anesthesia or pain medication in childbirth, most women fall into one of three categories:
Those who would prefer to give birth without any medications/anesthetics
Those who are unsure of pain relief options, and how medications might affect their labor and delivery
Those who are certain they will want medication for pain relief
Expectant moms should think about both patients, themselves and baby, when making choices about pain medication or anesthesia. Ideally, mom would want to have enough pain relief to deliver the baby with minimal pain, anxiety and side-effects. Plus, most moms will want to fully participate in the birth experience and be able to push when it is time to do so.
Pain Management Options
One of the most common methods of treating labor pain is Intravenous (IV) medications injected into a vein. They help reduce the pain of labor and may reduce anxiety. IV medications will probably not relieve the pain completely, but may be enough to make the delivery a tolerable experience. These medications are usually given in the early and active stages of labor to help mom rest and relax.
Local Anesthesia – A series of shots or injections that numb a small area of the body. They help mom feel more comfortable during the second stage of labor, or can be given if mom needs stitches after the birth.
Spinal (Intrathecal) Narcotic - Pain medication that is injected through the
back into the intrathecal space and is typically given only once. Pain relief
is rapid and lasts for about two to three hours. The ability to walk and move
around is maintained.
Epidural/Patient Controlled Epidural - Continuous infusion of pain medication that
blocks or numbs most pain from contractions during labor for up to 16 hours. It
is delivered through a tiny catheter that is placed through the back into the
epidural space. Pressure is still felt but relaxation and sleep are often
possible while labor continues. Depending on the circumstance, the laboring
mother is given control to give herself an extra dose of medication if needed
through a hand held button called a PCEA.
Combined Spina/Epidural (CSE) - Method of pain management that combines the
fast-acting Intrathecal and its flexibility to remain mobile with the ability
to extend pain relief later with the longer-lasting Epidural.
General Anesthesia – Used only for complicated deliveries or emergency cesarean sections. The patient is given medication through an IV and breathes anesthetic gases. General anesthetic can be administered quickly and is the best choice when there is an emergency situation.
It's Your Choice
You make the choice about pain management during labor and delivery. Remember, no one experiences childbirth the same way. Your pain management options depend on many things, including your progress in labor, your health history and any conditions that come up during your labor. You can feel safe in knowing the doctor and nurses will carefully evaluate your condition, make medical judgments, take appropriate safety precautions and present your options to you so that you can make an informed decision about your care.
Additional Medical Pain Relief Options
- Narcotics – Some women choose narcotic medication during labor, as it can take the edge off of contraction pain and provide a short period of pain relief and rest. The medication can be given intravenously (through an IV) or intramuscularly (as a shot) and is safe for mom and baby when given during labor. Sometimes this is just enough pain relief to help mom get through the toughest part of labor, and sometimes a mom might decide to proceed with one of the above mentioned anesthesia options as her labor progresses.
- Pudendal Blocks – A type of local anesthesia that can help reduce the pain involved with pushing during the second stage of labor. Though not commonly done, it can provide pain relief prior to an episiotomy or vacuum delivery, or can be used for the mom who experiences stretching pain at the perineum. It involves injecting a numbing medication into the vaginal wall shortly before delivery to block pain in the vagina and perineum. It usually works within 10 minutes and lasts for up to one hour.
Non-Medicated Pain Management Options
Moms wishing to have non-medicated births also have many options when it comes to coping with the pains of labor and delivery.
- Labor Support Person – A labor support person is encouraged and promoted, as this can be one of the best resources you have during childbirth. Your labor support and Childbirth Center nurses will help find comfort measures to assist you in coping with labor. This can be accomplished using breathing techniques, walking, swaying, or sitting on a birthing ball.
- Hydrotherapy – Many mom-to-be enjoy the relaxation of hydrotherapy by taking a whirlpool bath or shower.
- Essential Oils – These are provided by the Childbirth Center as a safe, effective way to promote relaxation and pain relief. If you wish to bring your own oils from home, please make sure your doctor says they're safe for you and your baby.
- Doulas – The SSM Health St. Clare – Baraboo Childbirth Center also has nurses on staff who've received Doula training, massage therapy training, and have even learned acupressure techniques. These nurses have shared their knowledge with the nursing staff to ensure everyone is able to provide the services to patients looking for a non-medicated birth experience.