A concern that most pregnant women have is how they will cope with the pain of labor and childbirth. Because you cannot tell in advance how your labor will progress, you should become educated about the forms of pain control that are available so that you can make an informed decision.
Types of Pain Relief
Having pain, or getting relief for it, should not be thought of as a sign of failure or a reason for guilt. Each person’s perception of pain is unique. Each woman’s labor is different and everyone experiences pain differently. That is why it is important that the decision you make about pain relief be the right one for you.
Behavioral Techniques
Many women take a childbirth preparation class in order learn what to expect during labor and birth. They learn breathing methods, relaxation techniques, and other ways of coping with pain and discomfort during childbirth. These classes can be valuable, and some women are able to use these techniques to get through childbirth without the need for pain medication. Childbirth preparation techniques can help a woman manage pain during labor and birth, but they usually don’t completely remove the pain. In the Women’s Life Center, you can sit in a hot shower, walk, or use the birthing ball, along with other position changes to help relieve the discomfort of labor. Research has shown that having the laboring woman participate in the decision-making process about her labor management is crucial to feeling positively about the birth, regardless of labor being and “easy” or a “difficult” one.
Pain Relief Measures Systemic Analgesia (IV medication)
Systemic analgesics provide relief over the entire body without causing loss of consciousness.
They act on the whole nervous system, rather than on one particular area. Systemic analgesics are often given as an injection into a muscle or vein. Sometimes other drugs are given with systemic analgesics to relieve tension or nausea. While these drugs do not completely get rid of pain, they do lessen its intensity.
Systemic analgesics may cause drowsiness and may make it hard to concentrate. Because these drugs can slow the baby’s reflexes and breathing at birth, they are usually avoided just before delivery.
Epidural Block
Epidural block, another form of local anesthesia, affects a much larger area than any of the methods described above. It numbs the lower half of the body to a varying extent, based on the drug and dose used. An epidural block is injected into the lower back, where the nerves that receive sensations from the lower body meet the spinal cord. This kind of anesthesia is helpful for easing the pain of uterine contractions, the pain in the vagina and rectum as the baby descends, and the pain of suturing. While the drug is working, you may lose some muscle control which makes it harder to “bear down” during the second stage of labor.
Epidural block can have some side effects. It may cause the mother’s blood pressure to drop, which in turn may slow the baby’s heartbeat. Preventive measures are taken to avoid this: before you can receive an epidural, you will be given 1500cc of IV fluids; once the epidural is placed, you will be positioned on your side to help circulation; you may receive medicine through your IV that will help correct your blood pressure and the baby’s heartbeat; you may be given an oxygen mask to breathe through to help increase the amount of oxygen the baby receives.
With epidural anesthesia, it may be harder for the mother to bear down and push the baby through the birth canal. It may be necessary for the baby to be delivered with forceps or with a vacuum extraction, special instruments that are placed around or attached to the baby’s head to help guide the baby out of the birth canal.
If the covering of the spinal cord is punctured when the drug is given, the drug may enter the spinal fluid or a vein. You may then get a severe headache, which can last for a day or more. If the drug enters a vein, it could cause dizziness or very rarely, seizures. Special precautions are taken to avoid these problems.
Spinal Block
Spinal block is the pain relief method most often used for cesarean birth. A spinal block numbs the lower half of the body. It provides good relief from pain, starts working quickly, and is effective in small doses.
Spinal block can sometimes cause some of the same side effects as epidural block: headaches, a drop in the mother’s blood pressure and a drop in the baby’s heartbeat.
Local Anesthesia
Local anesthetics can be used in the vagina or the surrounding area to ease pain during delivery.
Local anesthetics usually affect a small area, and so are especially useful to repair an episiotomy or laceration.
One advantage of local anesthesia is that it rarely affects the baby. After the anesthetic wears off, there are no lingering effects. The main drawback of these drugs is that they do not relieve the pain of contractions during labor.
General Anesthesia
General anesthetics are medications that make you lose consciousness. General anesthesia is used for cesarean delivery or other urgent situations.
These drugs are given through a face mask or through the IV line. Once the drug is given, it works very quickly, and is usually given just before delivery.
When general anesthetics are used during childbirth, the patient’s stomach may not be empty which may cause vomiting. Special precautions are taken to avoid this complication. After you are asleep, a tube will probably be placed in your throat to help you breathe.
After general anesthesia wears off, you will feel woozy and tired for several hours after waking up. You may also feel sick to your stomach; this feeling usually fades within a day. Also, your throat may be sore from the tube that was used to provide oxygen.
Recovery from Pain Medications
What you experience as you recover from pain medications will depend on the type that was used. In any case, once it wears off, you may feel some pain around the vagina, perineum, lower abdomen, or back, depending on how much the muscles and tissues were strained during
delivery.
Finally…
Many women worry that anesthesia given during labor or childbirth will somehow make the experience less “natural.” The fact is, no two labors or births are the same, and no two people have exactly the same ability to tolerate pain. Some women require little or no pain medication, while may others find that pain relief gives them a better sense of control over their labor and birth.
Be prepared to be flexible. Some of the techniques described here may appeal to you more than others. As your care providers, we are dedicated to working with you to have the birth
experience that you want and to help you make informed decisions.
INFORMATION REGARDING DISABILITY FORMS
During the course of your pregnancy, you may require our assistance with the completion of disability forms for your insurance company, your employer, credit card companies, and so forth.
We will be happy to complete these for you, and we want you to be aware of our policies.
1. There is a $10.00 charge per form, and payment is expected prior to completion of the form.
2. Forms will be completed within ten business days.
3. Forms may be picked up personally or mailed via a self-addressed, stamped envelope.
We cannot fax disability forms.
Thank you.