Women experience and tolerate pain differently.
For some pregnant women, focused breathing is all they need to get through labor and childbirth; but for others, numbing of the pain is desired.
There are a number of different medications a woman can take during labor and childbirth. It is important for you to learn what pain relief options are available. Please discuss the options with your health care provider well before your "birth day" so that when you are in labor you understand the choices.
Also, keep in mind that your pain relief choices may be governed by certain circumstances of your labor and delivery. Throughout your labor, your health care provider will assess your progress and comfort and help you choose a pain relief technique.
Getting pain relief should not cause you to feel guilty. You are the only one who knows how you feel, so decisions regarding control of your labor pain must be made specifically by you. Moreover, do not worry about the safety of the medicine. All medications provided during childbirth are considered safe for both you and your baby.
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What are my options?
You may have several options for how you want your pain medication delivered:
• Systemic medications Systemic painkillers such as narcotics dull your pain but don't completely eliminate it. You may also be given a tranquilizer — alone or in combination with a narcotic — to reduce anxiety or nausea, or to relax you. Systemic drugs are either delivered through an IV line to your bloodstream or injected into a muscle, and they affect your entire body rather than concentrating pain relief in the uterus and pelvic area. They may make you feel sleepy, but unlike the general anesthesia that's often given for surgery, they won't make you unconscious.
• Epidural An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. Medication is delivered through a catheter, a very thin, flexible, hollow tube that's inserted into the epidural space just outside the membrane that surrounds your spine. The medication is usually a combination of a local anesthetic and a narcotic. Local anesthetics block sensations of pain, touch, movement, and temperature, and narcotics blunt pain without affecting your ability to move your legs. Used together, they provide good pain relief with less loss of sensation in your legs and at a lower total dose than you'd need with just one or the other.
• Spinal block A spinal differs from an epidural in two ways: It's delivered directly into the spinal fluid (and not into the space surrounding your spine), and it's a one-time injection rather than a continuous feed through a catheter. As a result, relief is rapid and complete but lasts only a few hours. Your practitioner may order a spinal block if you decide you want pain relief late in labor or if you're progressing so rapidly that delivery is likely to be sooner rather than later and you can't wait for an epidural.
• Combined spinal/epidural A combined spinal/epidural block is a newer technique that offers the rapid pain relief of a spinal and the continuous relief of the epidural. In early labor, this technique can work like a walking epidural because you rely primarily on the narcotics in the spinal injection for pain relief for the first hour or two (which allows you to continue to walk around). Then you have the epidural to fall back on once the spinal starts to wear off. In more active labor, you may opt for a combined spinal/epidural so you get immediate relief from the spinal while you're waiting for the epidural to work.
