When Pregnancy Goes Past Your Due Date
What is the due date? The date your baby is due—your estimated due date (EDD)—is calculated from the first day of your last menstrual period (LMP). The EDD is used as a guide for checking your
Considering Pain Relief During Child Birth?
You can ask for pain relief during labor. You should not feel pressured to choose a particular option by your partner, friends, family members, or health care professional. Only you know how you feel and how you handle pain. It is also OK to change your mind about which pain medication you want to use.
The use of pain medications does not make your labor “less natural.” It also does not increase the likelihood that you will have a cesarean birth. Pain relief medications can help you better cope with labor and delivery.
The medications used to relieve pain during labor and delivery have no long-term effects on the baby. They also have no effect on a child’s later development.
When should I decide about pain relief during child birth?
During one of your prenatal care visits, discuss your pain relief options with your obstetrician–gynecologist (ob-gyn). You do not need to make a decision about using medication until you are actually in labor. But it is a good idea to find out what types are available at your hospital or birthing center and think about your options before your labor starts.
What medical conditions can affect my pain relief options?
Medical conditions that may affect your pain relief options include heart disease, certain blood disorders, liver disease, and previous spinal surgery. If you have one of these conditions, or if you have any questions about pain relief, you may be scheduled to meet with an anesthesiologist. You can do this before you go into labor or when you arrive at the hospital in labor.
What types of medications are used?
In general, there are two types of pain relief methods:
- Analgesia: Analgesia relieves pain without loss of feeling or muscle movement. The medications are used to lessen pain but usually do not stop pain completely.
- Anesthesia: Anesthesia relieves pain by blocking most feeling, including pain.
Analgesia medications are called analgesics. Anesthesia medications are called anesthetics.
Pain relief medications can be either systemic, regional, or local. Systemic medications affect the entire body. Local medications affect only a small area of the body. Regional medications affect a region of the body, like the region below the waist.
What are other ways to ease pain during childbirth?
Nonmedical pain relief approaches can be used alone or in addition to medications. Here are some ways to ease the discomfort you may feel during labor:
- Do relaxation and breathing techniques taught in childbirth class.
- Have your partner massage or firmly press on your lower back or massage your feet. Your partner can also use tennis balls for massage.
- Change positions often.
- Take a shower or bath, if permitted.
- Have your partner place an ice pack or warm compress on your back.
- If you feel warm, ask your partner to soothe you with cool, moist cloths.
- Visualize yourself in a favorite place such as a beach or garden.
- When contractions are closer together and stronger, rest in between and take slow, deep breaths.
Systemic Analgesia (Opioids)
What is systemic analgesia?
Systemic analgesia acts on the whole nervous system, rather than a specific area, to lessen pain. The medications used are known as opioids. These drugs reduce your awareness of pain and have a calming effect. They will not cause you to lose consciousness.
How is systemic analgesia given?
Systemic analgesics are usually given as a shot or through an intravenous (IV) line. This is a small tube that is placed into a vein through which medications or fluids are given.
Medication can be released into your IV line by a health care professional or when you press a button. The amount of medication you can give yourself is limited, so it is not possible to give yourself too much.
What are the side effects and risks of systemic analgesia?
Side effects are minor and include itching, nausea, vomiting, feeling drowsy, or having trouble concentrating. A medication may be given to relieve nausea. High doses of systemic analgesics can cause you to have breathing problems.
Opioids can affect your baby’s breathing and heart rate for a short time. Your baby may be drowsy, which can make it harder for your baby to breastfeed in the first few hours after birth. You may not be able to get systemic analgesics within the hour before delivery.
Nitrous Oxide (Laughing Gas)
What is nitrous oxide?
Nitrous oxide, commonly known as “laughing gas,” is a tasteless and odorless gas used as a labor analgesic by some hospitals. It reduces anxiety and increases a feeling of well-being so that pain is easier to deal with. It does not numb pain.
How is nitrous oxide given?
Nitrous oxide is mixed with oxygen and inhaled through a mask. You hold the mask yourself and decide when to inhale. It works best when you begin inhaling 30 seconds before the start of a contraction.
How is nitrous oxide given?
Nitrous oxide is safe for you and your baby. You may feel dizzy or nauseous while inhaling nitrous oxide, but these sensations go away within a few minutes.
Local Anesthesia (Pudendal Block)
What is local anesthesia?
Local anesthesia is the use of drugs to prevent pain in a small area of the body. You may have already had local anesthesia if you have had a cavity filled at the dentist’s office.
How is local anesthesia given?
The medication is injected into the area around the nerves that carry feeling to the vagina, vulva, and perineum. This is called a pudendal block. When used to relieve pain during childbirth, the medication is given just before delivery.
Local anesthesia is also used when an episiotomy needs to be done or when tissues need to be repaired after childbirth.
What are the side effects and risks of local anesthesia?
Rarely, there may be an allergic reaction to a local anesthetic, or you may have nerve or heart problems if the dose given is too high. Local anesthesia rarely affects the baby.
Local anesthesia is also used when an episiotomy needs to be done or when tissues need to be repaired after childbirth.
Regional Pain Relief (Epidural Blocks and Spinal Blocks)
What are regional analgesia and regional anesthesia?
Regional analgesia and regional anesthesia act on a specific region of the body. During labor and delivery, they are used to lessen or block pain below the waist. These methods include the epidural block, spinal block, and combined spinal–epidural (CSE) block.
Typically, the medication includes an anesthetic that may be mixed with an opioid analgesic. The medication may be given as a single shot or through a thin tube (a catheter) placed in the lower back.
These techniques provide pain relief with few side effects.
What is an epidural block?
An epidural block (also called “an epidural”) is the most common type of pain relief used for childbirth in the United States. In an epidural block, medication is given through a tube placed in the lower back.
For labor and vaginal delivery, a combination of analgesics and anesthetics may be used. You have some loss of feeling in the lower areas of your body, but you remain awake and alert. You should be able to bear down and push your baby through the birth canal.
For a cesarean birth, the dose of anesthetic may be increased. This causes loss of sensation in the lower half of your body.
An epidural also can be used for postpartum sterilization.
Typically, the medication includes an anesthetic that may be mixed with an opioid analgesic. The medication may be given as a single shot or through a thin tube (a catheter) placed in the lower back.
These techniques provide pain relief with few side effects.
How is an epidural given?
An epidural may be given soon after your contractions start or later as your labor progresses. It is typically given by an anesthesiologist or other specialized health care professional.
Before the epidural is given, your skin is cleaned and local anesthesia is used to numb an area of your lower back. You sit or lie on your side with your back curved outward. You stay in this position until the procedure is completed.
A needle is inserted into a small area in your lower back. After the needle is placed, a thin tube is usually inserted through it, and then the needle is withdrawn. The tube stays behind, and medication then can be given as needed through the tube. You may be able to control the supply of medication yourself.
Pain relief should begin within 10 to 20 minutes after the medication has been started.
Will I be able to move or feel anything after receiving an epidural?
You can move with an epidural, but you may not be able to walk. Although an epidural block makes you more comfortable, you may still be aware of your contractions. You may also feel vaginal exams as labor progresses.
What are the side effects of an epidural?
When opioids are used, itching is common. This itching can be treated with another medication. Other less common side effects related to opioids include nausea, vomiting, and breathing problems.
Less common side effects include the following:
- Decrease in your blood pressure
- Fever
- Headache
- Soreness
Other side effects include shivering, difficulty emptying your bladder, and reactivation of cold sores (oral herpes).
What are the risks of an epidural for me?
Serious complications with epidurals are very rare and include the following:
- Breathing problems if the anesthetic enters your spinal fluid and affects your breathing muscles
- Numbness, tingling, or rapid heartbeat if the anesthetic is injected into a vein instead of a nerve
- Injury to your spinal cord or nerves
What are the risks of an epidural for my baby?
What is a spinal block?
What is a combined spinal–epidural block?
General Anesthesia
What is general anesthesia?
What are the risks of general anesthesia?
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After going to another clinic in Cheyenne that didn’t treat me as a priority, it was a breath of fresh air stepping into Cheyenne Women’s Clinic. The entire staff was amazing, but Dr. Dozier was exceptional. She was kind, patient & answered any questions I had with great detail. I will never not recommend her. I am so pleased with my experience here.
I feel so lucky to have had the doctors at the Women’s Clinic for all three of my deliveries and GYN care. They provide high quality, compassionate, evidenced based care and Cheyenne is lucky to have such a great group!
I absolutely have loved it here! We just finished having our second kiddo and have worked with the vast majority of doctors here and they are all excellent!
Had an absolute amazing experience with the Cheyenne Woman’s Clinic during my first pregnancy. They did their best to accommodate my labor desires and made me feel as comfortable as can be. My husband appreciated how they took care of me, and now we’re going back with our second pregnancy! Highly recommend.
All of my appointments I’ve attended through the Women’s Clinic have been amazing the nurses and doctors have been lots of help throughout my whole pregnancy with lots of advice and support, I love every person from there they definitely are a welcoming and loving place!
