Pain Management

Each woman's labor is unique. The amount of pain a woman feels during labor may differ from that felt by another woman. Pain depends on many factors, such as the size and position of the baby and the strength of contractions.

Some women take classes to learn breathing and relaxation techniques to help cope with pain during childbirth. Others may find it helpful to use these techniques along with pain medications. The decision to use medical pain relief is entirely yours and there is no "right" or "wrong" decision. Your doctor can give you guidance and answer any questions you have about your pain relief options.

There are two types of pain-relieving drugs - analgesics and anesthesia - that can be used during labor and delivery. Analgesics relieve pain without total loss of feeling or muscle movement. They do not always stop pain completely, but they do lessen it dramatically. Anesthesia blocks all feeling, including pain. Some forms of anesthesia, such as general anesthesia, cause you to lose consciousness.

Easing Discomfort

Some natural ways to relieve discomfort during labor:

Some women need little or no pain relief, and others find that pain relief gives them better control over their labor and delivery. Talk with your doctor about your options.
• Do relaxation and breathing techniques taught in childbirth class.
• Have your partner massage or firmly press on your lower back.
• Change positions often.
• Take a shower or bath, if permitted.
• Place an ice pack on your back.
• Use tennis balls for massage.

Regional anesthesia tends to be the most effective method of pain relief during labor and causes few side effects. Epidural anesthesia, spinal blocks, and combined spinal-epidural blocks are all types of regional anesthesia that are used to decrease labor pain.

Epidural anesthesia, sometimes called an epidural block, causes some loss of feeling in the lower areas of your body, yet you remain awake and alert. An epidural block may be given soon after your contractions start, or later as your labor progresses. Your doctor will work with you to determine the proper time to give the epidural. Pain relief will begin within 10-20 minutes after the medication has been injected.

A spinal block, like an epidural block, is an injection in the lower back. While you sit or lie on your side in bed, a small amount of medication is injected into the spinal fluid to numb the lower half of the body. A spinal block brings good relief from pain and starts working fast, but it lasts only an hour or two. A spinal block usually is given only once during labor, so it is best suited for pain relief during delivery.

A combined spinal-epidural block has the benefits of both types of pain relief. The spinal part helps provide pain relief right away. Drugs given through the epidural provide pain relief throughout labor.

Unlike analgesics or regional anesthesia, general anesthetics are medications that put you to sleep (make you lose consciousness). If you have general anesthesia, you are not awake and you feel no pain. General anesthesia often is used when a regional block anesthetic is not possible or is not the best choice for medical or other reasons. It can be started quickly and causes a rapid loss of consciousness; therefore, it is often used when an urgent cesarean delivery is needed.