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Monday, January 20, 2020

Pain relief during childbirth: medical and non-medical options

Pregnant woman holding back on exercise ball
Often, one of the most anxiety-inducing parts of pregnancy comes at its end: labor and delivery. Some of our patients joke that they want us to meet them in the hospital parking lot with an epidural when they arrive, and others are determined to deliver “naturally.” But when it comes to pain relief during labor and delivery, there is no right or wrong answer, just a range of options.

All deliveries are natural, but there are both medical and non-medical choices for pain relief, and the choice is personal. Each woman and each delivery is different, and what worked for your friend might not be what works for you. Even if you’ve had more than one child, you might find a different form of pain control works better for each birth.

Medical pain relief
When it comes to medications for pain relief, an epidural is probably the most well-known. With this option, an anesthesiologist uses a needle to insert a small catheter near your spinal cord. We can then administer the medication through this tiny tube to block feeling in the lower body. An epidural takes 10 to 20 minutes to work, with additional doses given through the catheter as needed throughout labor and delivery.

A spinal block is similar to an epidural but without the catheter. The anesthesiologist injects the medication directly near the spinal cord usually as a one-time dose. It takes effect immediately and lasts an hour or two, so it’s typically administered close to the time of delivery. An epidural and spinal block can also be combined to provide both quick and long-lasting pain relief.

Analgesics provide whole body pain control without loss of feeling, an option best used during early labor. Depending on the type, we can administer the medication by injection, through an IV, or by inhalation—a mixture of nitrous oxide (laughing gas) and oxygen is effective for some women. A local anesthetic (pudendal block) is another option we can use shortly before delivery to block pain around the vagina.

Non-medical pain relief
There are a lot of effective, non-medical techniques women can use to help with pain during childbirth as well, including:
·         Moving and changing positions—walking, swaying, yoga
·         Using a birthing ball or a rocking chair
·         Massage, touch, acupuncture or acupressure
·         Relaxation techniques such as deep breathing, meditation or hypnosis
·         Creating a calm setting by dimming lights, listening to music, using aromatherapy
·         Ice or heat packs
·         A warm shower or use of a birthing tub

These techniques don’t stop the pain, but they may help you better cope with it. We can also combine medical and non-medical pain control methods. For example, you may find deep breathing and yoga helpful during early labor, and then request a spinal as delivery becomes imminent.

We find that many of our patients feel more in control when the big day comes if they understand their pain control options and have a plan ahead of time. We’ll talk to you about the advantages and risks that come with each method so you have a sense of how you would like to proceed. You can always change your mind if the pain is more or less intense you expected.

How you choose to approach pain management during childbirth is a personal choice, and we’re happy to help you create the birth experience that will be best for you.