Pain Relief During Labor and Delivery: Your Medication Options

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As your baby’s due date approaches, you’ll have a million things going through your mind at once. One of those that tends to stand out is: how much is labor and delivery going to hurt? Fortunately, there are several options for pain relief beyond the breathing and relaxing you learn in childbirth class.

There are two primary kinds of pain relief medications that are safe to use during childbirth: analgesics and anesthetics.

  • Anesthetics (think: anesthesia) relieve pain by blocking most feeling, including muscle movements.
  • Analgesics lessen pain without causing you to lose feeling or muscle movement. They blunt how you perceive pain and your emotional response to it.

Your doctor can use these medications to affect your body in three different ways:

  • Systemically – the medication affects your whole body
  • Regionally – the medication affects only part of your body
  • Locally – the medication affects only a small part of your body

Anesthetics for Pain Relief

Local Anesthesia

Your doctor may use local anesthesia on the nerves around the vagina, vulva, and perineum to provide pain relief during childbirth, especially if you need to have an episiotomy (a small incision that allows the baby to emerge easier) or you need to have some torn tissues repaired right after childbirth.

Side effects:

  • Rarely, local anesthesia causes an allergic reaction and it rarely affects the baby.

General (Systemic) Anesthesia

General anesthesia is usually used only in emergency situations during childbirth, such as if you need to have an emergency cesarean section (C-section). It takes effect quickly – you are not awake, and you don’t feel pain under general anesthesia.

Side effects:

  • A rare, but serious, side effect can occur if there is undigested food in your stomach. If it comes back come up into your mouth while you are unconscious and you inhale it, you may develop pneumonia.
  • General anesthesia can also affect your baby. It may decrease his or her breathing rate, causing him or her to be less alert.

Analgesics

Systemic Analgesics

Systemic analgesics, which are usually some form of opioid medication, help to make you less aware of your pain and help to you calm down. Your doctor will give you this medication as a shot or through an IV line.

Side effects:

  • Itching is common with opioids. You may also experience nausea, vomiting, drowsiness, or a reduced ability to concentrate.
  • The medication may temporarily affect your baby’s breathing and heart rate and cause him or her to be drowsy, which may make it harder to breastfeed at first.

Anesthetic and Analgesic Combinations

Regional anesthesia and analgesia combinations are used to reduce or block pain below your waist.

Epidural Block

Commonly referred to as “an epidural,” this is the most common pain relief for childbirth in the U.S. Usually given to you through a tube inserted into your lower back, it provides continuous pain relief while allowing you to remain awake and alert. You do lose some feeling in the lower areas of your body, which is what helps to reduce the pain, but you will still be able to push when it’s time. If your doctor uses an epidural during a cesarean delivery, he or she may use more anesthetic in the mix than for a vaginal delivery.

Side effects:

  • It is common to feel some itching from the opioids, and you may also experience nausea, vomiting, and, if the medication affects the muscles that help you breathe, you may experience some temporary breathing problems.
  • The medication may temporarily affect your baby’s heart rate and breathing and cause him or her to be drowsy.

Spinal Block

This medication is given as a single shot into the fluid around your spinal cord. It works to relieve pain quickly, but it only lasts for an hour or two. A spinal block is often used for cesarean deliveries.

Side effects:

  • A spinal block has the same side effects as an epidural.

Combined Spinal-Epidural Block (CSE Block)

This block has the benefits of a spinal block (it quickly relieves pain) and an epidural (it provides continuous pain relief). With the combination, your doctor can use lower doses of medication than with an epidural for the same level of pain relief. This reduces the potential for side effects.

Side effects:

  • A CSE block has the same side effects as an epidural.

 

As your due date gets close, your doctor will talk with you about your options for pain relief during childbirth and let you choose the plan that you feel is best for you. But don’t hesitate to ask about pain relief at any of your appointments.

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