You can discuss pain management options in advance with your prenatal care provider or ask your delivery room care team if you have any questions.
In hospitals, certain drugs can be administered to ease birthing pains. The following options may be offered to you: an epidural, narcotics, nitrous oxide gas, or a pudendal nerve block. These methods are described below.
Ask in advance which of these options are available at your hospital.
Epidural anaesthesia, often referred to as an epidural, is the most effective method for relieving childbirth pain. It involves injecting a local anaesthetic through a flexible tube (catheter) inserted between two vertebrae in the lower back. The drug numbs the nerves in the abdominal area and partially numbs the leg nerves.
The epidural reduces or eliminates the pain of labour while allowing contractions to continue. However, it can diminish contractions and prevent you from moving around as freely as before. This can slow the baby’s descent.
If you want to have an epidural, an evaluation will first be done to ensure, among other things, that this type of anaesthesia is not contraindicated for you.
Good to know…
It is best not to receive an epidural too soon, to ensure that your labour is well underway. On the other hand, you may not be able to have it in time to relieve your pain before the push.
Before receiving an epidural, you will be connected to an intravenous solution (IV) that will remain in place until after the medication stops working. You will also probably be hooked up to a continuous fetal monitor, especially if you are given drugs to stimulate your contractions (see Stimulating labour).
In some hospitals, you can still walk around and go to the bathroom while under an epidural. Ask your care provider.
However, if you have problems urinating, you may need a urinary catheter.
The effects of the epidural may make it more difficult to know how to push. This is why there may be a greater need to use vacuum extractors or forceps to deliver a baby when the mother has an epidural. Epidurals do not increase the risk of having a caesarean.
Narcotics are analgesics administered as injections into a muscle or vein. They decrease the sensation of pain without eliminating it completely. They are mainly used during the early phases of labour when the pain level is still low. The more the pain increases, the higher the dose needed to relieve it.
The possible side effects of narcotics also increase with the dose. These drugs can make you sleepy and nauseous and affect your heart rate. The baby may also experience some of these effects. That’s why narcotics are not normally used at the end of labour.
Sometimes the baby requires medical monitoring for a few hours after birth until the drugs are eliminated from his system. However, these drugs have no long-term effects on the mother or baby.
Nitrous oxide, also known as “laughing gas,” is administered through a breathing mask. It partially relieves pain during labour. Nitrous oxide can cause nausea and dizziness, but is generally well tolerated.
Pudendal nerve block
A pudendal nerve block is a pain medication administered just before the push. Its purpose is to reduce perineum and vaginal pain during childbirth. Using a long needle, an anaesthetic is injected into the two pudendal nerves through the vagina.
Labour: Process by which the baby passes from the uterus to the outside world, primarily through contractions of the uterus.
Urinary catheter: A flexible tube that allows urine to drain freely from the bladder. The catheter is inserted into the bladder through the urethra.
Perineum: The part of the body between the vagina and the anus.