Women's Health

Maternity

Labor and Delivery

Pain Management and Anesthesia

A good first step in managing the pain in labor is to attend childbirth classes to learn breathing and relaxation techniques as well as other comfort measures that will promote your ability to work with your labor. Breathing and relaxation techniques promote a good oxygen supply to both mother and baby and can help labor move along by reducing anxiety. These techniques, like other behavioral strategies, require practice with your support person outside of class and on a regular basis until you go into labor. Practice sessions can easily fit into your lifestyle with a little creativity. Practice breathing patterns during car rides, while watching television, or while doing the laundry.

Each woman responds to the pain of labor in her own way. Every labor is unique. Some women find that they are able to use breathing and relaxation techniques for their entire labor. Others find that their labor is too long or too strong for them to manage with breathing and relaxation techniques alone. A variety of medications and types of anesthesia are available to assist in pain management.

The following types of medication/anesthesia are available:

Synthetic Narcotics

Nubain is the name of a synthetic narcotic used to manage labor pain. This medication is given either in the form of an injection or through an IV should you have one already in place. Once Nubain is given, relaxation and a dulling of labor pain should occur. Nubain does not take away the sensations from your contractions but can make it easier to tolerate them.

Epidural Anesthesia

Epidural anesthesia may be used for management of labor pain or for Cesarean births. Medication like the Novacaine you may have been given at the dentist is delivered into the epidural space in your spinal column. Prior to starting the epidural, you may be given some IV fluids to prevent lowered blood pressure. A thin tube (called a catheter) is inserted between two of your vertebrae in your back. When the tube is in place, a test dose of the medication is given to ensure that you are tolerating the medication well. Once that is determined, your epidural will be “dosed up” to provide numbness. You may experience relief within 15-30 minutes.

In addition to IV fluids, you may be given a urinary catheter to empty your bladder. The anesthesia does not allow you to feel the need to go to the bathroom and the catheter prevents your bladder from becoming overly full.

Continuous fetal monitoring is used with epidural anesthesia to ensure that the uterus continues to contract effectively and that the baby is tolerating labor well. Should contractions weaken in response to the anesthesia, the synthetic hormone, Pitocin, may be added to your IV to support the labor process.

It is important to discuss your interest in epidural anesthesia with your health care provider. They can give you their perspective on how epidurals can be used in labor and review effects and side effects of epidural use so that you can make an educated decision about this method of pain management.