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Managing Pain During Labor: Are You Ready?

Giving birth is one of the most exciting and important events of your life. Childbirth can also be physically and mentally challenging. The good news is that there are many safe pain management options available to you during labor. If you are pregnant, it is important to plan ahead and review your preferences with your Ob/Gyn before you go into labor.
In early labor, you may be able to ease your discomfort with some simple activities that can be done at home:

  • Drink plenty of water. Dehydration can cause false contractions.
  • Take a hot shower or bath.
  • Go for a walk.
  • Rest or take a nap. Don’t worry, you won’t sleep through labor!
  • Contact your doctor if you are unsure about what to do.

As your labor progresses and it is time to deliver, you have several options for pain relief. Or, if you prefer, you can elect to have a delivery without medication or with minimal intervention. Pain is not a requirement of having a baby, so some women choose to reduce the discomfort of childbirth.
Initial steps to manage uncomfortable contractions can include focused breathing and relaxation exercises. Anxiety about the pain (or anticipated pain) of labor can cause distress and make you tense up. Position changes, birthing balls, massage and water therapy can also help manage contractions and relax your body. You may need to try different techniques to see what works best for you.

If these options are not enough to control your discomfort, you can consider adding nitrous oxide gas, injected pain medication, or an epidural.

Nitrous oxide therapy or “laughing gas” involves breathing in a mixture of nitrous oxide and oxygen gas. It does not require an injection or IV (intravenous) access, and it can be used as an alternative to an epidural or prior to receiving other forms of pain management. Nitrous oxide can take the edge off of the contractions and provide a minimally invasive patient-controlled pain relief method. It is a safe therapy that can be used in labor, while pushing, or even immediately after delivery.

Medicine can also be injected into a vein (IV) or muscle to provide relief and help you rest. In most cases, the pain medicine is an opioid such as morphine or fentanyl. Opioids can relax your body and decrease your perception of discomfort, but they may also make you drowsy.

An epidural (or a spinal) can deliver pain medication near the nerves in your lower back. Although epidurals help relieve uncomfortable contractions, usually you will still feel pressure. An epidural allows you to be awake and alert during labor even if a cesarean section is required.

In rare situations, a doctor will use general anesthesia. This is where you are completely unconscious for the delivery. This is usually only done in emergency situations. Because of potential risks to the mother and the baby, general anesthesia is not a preferred choice.

Prepare for childbirth by learning about the different pain management options available to you, and discussing your preferences with your Ob/Gyn and birth support team. Giving birth can be an unpredictable process, so it is a good idea to have a plan that takes into account different situations. The better you understand your choices for managing the discomforts of labor in advance, the more you will be able to focus on the momentous process of giving birth.

Tamara R. Pringle, MD, FACOG
Bon Secours Richmond OB-GYN
richmondobgyn.com