Patient Education

Pain Relief During Labor and Delivery

Although the birth of a new baby is a very exciting and happy time in a woman’s life, many pregnant women are concerned about the pain they may experience during labor and delivery. The truth is, the pain that is felt by one woman may be completely different than the pain felt by another. The good news is that there is pain relief for women in labor, and it can be very helpful to use together with relaxation and breathing tips. However, many women may wonder what type of pain relief is best for them and which will be the most effective. This page goes over the basic types of pain relief medications that are used during labor and delivery.

WHAT TYPES OF PAIN RELIEF ARE THERE FOR LABOR?

There are two different types pain medications used for labor- analgesics and anesthetics. Analgesics are drugs that are usually injected into the muscle to numb the pain. They do not usually eliminate the pain or feelings of pressure, but they greatly lesson them. Usually, analgesics are offered to women during vaginal labor. Anesthetics are drugs that completely block all feeling, sometimes even put you to sleep. They are most commonly used during surgical procedures like cesarean sections. When going into labor, you and your doctor will choose the type of pain relief that is safest for you.

HOW DO ANALGESICS WORK?

Analgesics are pain relief drugs that work by numbing the nervous system itself, instead of just a specific organ or tissue. Analgesia does not cause you to fall asleep or become numb. There are several different kinds of analgesia:

  • Systemic Analgesia: Systemic analgesia is most commonly given through a muscle or vein. Under systemic analgesia, you can may feel moderate amounts of pain and pressure. Oftentimes, it will produce negative side effects. These include drowsiness, nausea, and concentration failure. However, these are usually minor. 
  • Regional Analgesia: Regional anesthesia numbs a much greater area than that of local anesthesia or systemic analgesia, which is why it is considered a more popular pain relief during labor. It also usually produces no side effects. There are three different types of regional analgesia:
    • Epidural Analgesia: Epidurals are the most common form of pain relief during pregnancy. They work by blocking the feeling in the lower half of your body so you cannot feel any pain. They are given through an injection into your lower spinal cord, which usually takes around 10 to 20 minutes to take effect. Oftentimes, doctors will insert a small tube into the lower spine, through which more medication can be administered when needed. You may be able to slightly feel your doctor’s exams or contractions, but usually your anesthesiologist will adjust the levels of medication for your comfort. Sometimes, women experience side effects such as headache, decrease in blood pressure, or heaviness in the legs. However, these usually go away.
    • Spinal Block: A spinal block is similar to an epidural. Both are administered through an injection into the spinal area, and both bring fast pain relief. However, unlike epidurals, spinal blocks are injected right into the spinal fluid, and their effects last only 1 to 2 hours. Since it works immediately but wears off quickly, it is usually administered right before delivery. During a cesarean birth, a much larger amount of the drug is injected for more complete pain relief during the surgery. It is also used if the baby needs to be removed with forceps or vacuum.
    • Combined Spinal-Epidural Block: This method of pain relief uses both the epidural and spinal blocks, meaning that a woman gets both immediate relief from the spinal, as well as lasting relief from the epidural. It is also injected into the spinal fluid. Oftentimes, women will be able to walk after spinal-epidural blocks, which is why it is sometimes called the "walking epidural".

HOW DOES ANESTHESIA WORK?

Anesthesia works by numbing a specific area in order to eliminate pain completely. There are several different types of anesthesia:

  • Local Anesthesia: Local anesthesia provides pain relief by numbing a small specific area. However, during labor, it does not lessen the pain of contractions. Local anesthesia is most commonly applied to the vagina, so that you cannot feel any vaginal tears that may occur during birth.
  • General Anesthesia: General anesthesia is the medication that is used to put you entirely to sleep during the procedure. Usually, this type of pain relief is used when surgical procedures are needed, especially emergency cesarean births. General anesthesia can be administered immediately and causes the patient to fall asleep very quickly. Sometimes, general anesthesia can cause problems if there is food still remaining in the woman’s stomach during the procedure, which could potentially travel back up and into her lungs, causing choking. Usually, women under general anesthesia will receive a breathing tube to avoid such problems.

WHAT TYPE OF PAIN RELIEF WILL BE USED DURING CESAREAN BIRTHS?

The type of drugs you will receive will depend on the reason for your cesarean birth and the health of your baby. If the birth is expected to be easy and complication free, oftentimes you will receive a spinal or epidural block. If you already have a tube inserted in your back for an epidural, your doctor can then insert much stronger medications into it for pain relief for the cesarean birth. If your c-section is an emergency or will be very invasive, you will probably need general anesthesia.

IN CONCLUSION

Many women worry about the pain they may have during labor, and whether receiving pain relieving drugs will make the experience less natural. However, pain relief is extremely helpful in controlling the pain, and can be very helpful in allowing the mother to have a natural, more controlled and smooth birth. Talk to your doctor about which method of pain relief would be best for you.