Pain Management

Non-drug Pain Management:

• Preparation – Being prepared for all the possibilities during labor can actually make it less painful. Often fear and anxiety can cause more tension, which can increase pain. Attending childbirth classes can give you a range of different methods in dealing with non-drug pain management.
• Good support team
• Massaging techniques
• Changing positions
• Also see also Delivery Options.

Pain Management With Drugs:

• NARCOTICS – Blocks pain but does not remove it completely. These are usually not given until later into labor so that they do not reduce contractions. Given normally by injection or IV. Takes 10-30 minutes to go into affect and will last 2-4 hrs. May cause nausea and can cross the placenta and affect the baby.
• GENERAL ANESTHESIA – Pain medication that puts patient to sleep. Not normally used in regular vaginal births and only sometimes used in planned cesareans. This method is normally only used in emergency cesarean situations.
• LOCAL ANESTHESIA – Injection is given in the vagina or surrounding area to ease pain during delivery. This is helpful in easing pain if physician needs to make any incisions in the perineum or in cases of an episiotomy. Not really any known risks, but this method does not relieve pain of contractions.
• EPIDURAL BLOCK– Numbs you from the waist down, but leaves you completely conscious, while providing complete relief from pain. Given in active labor after 4-6 cm dilation. Administered by numbing a small part of the back, then inserting a needle and tube. Local anesthesia is injected which numbs the nerves that send messages to the brain. Since these nerves are numb, you cannot feel pain.
  Normally takes 20 minutes to take affect. Commonly used today in what is referred to as a “walking epidural.” This is a continuous low dose epidural that injects enough anesthesias to block pain sensations but does not immobilize legs. This lower dose decreases the risk of side affects that commonly occur with epidurals such as losing control over bottom half of body, and not being able to push and having to deliver with help of forceps. With both types of epidurals, there is the risk of the needle puncturing the spinal cord and resulting in severe headaches, infection or other serious affects.
• PARACERVICAL BLOCK– Local anesthetic is inserted into the tissue around the cervix to numb pain caused by cervical dilation. It lasts only 45-60 minutes and can cause the baby’s heartbeat to slow down.
• SPINAL BLOCK– Administered in the lower back like the epidural, but injected into the spinal fluid. Drug does not last long so most commonly given for pain relief during actual delivery and not during labor. Only administered once and is most common for cesarean births.