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How do most women manage the pain of labor and delivery?
Most moms-to-be in the United States choose some kind of pain medication (most commonly an epidural) to help them cope with labor. Some decide well before delivery day that they want pain medication, and some ask for relief when they find that labor isn't what they imagined. Others opt for medication if nature throws them a curveball and they end up with a long or complicated labor.
Keep in mind that the intensity of the discomfort during labor varies from woman to woman and from birth to birth.
"No woman can predict what sort of pain she'll have during labor or how she'll cope with it," says David Wlody, Chair of the Department of Anesthesiology at SUNY Downstate College of Medicine. "While some will manage very well with breathing and relaxation techniques, others will not. Try to keep an open mind about what your needs might be, and don't second-guess your decision after delivery."
What are my options?
You may have several options for how you want your pain medication delivered:
Systemic painkillers, such as narcotics, dull your pain but don't completely eliminate it. They affect your entire body rather than concentrating pain relief in the uterus and pelvic area.
Systemic drugs are either delivered through an IV line to your bloodstream or injected into a muscle. They may make you feel sleepy. However, unlike the general anesthesia that's often given for surgery, these drugs won't make you unconscious.
You may also be given a tranquilizer – alone or in combination with a narcotic – to reduce anxiety or nausea, or to relax you. In some hospitals, you may be offered nitrous oxide – laughing gas – which you inhale during contractions.
Learn more about systemic labor medications.
An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious.
Epidural medication is delivered through a catheter, which is a very thin, flexible, hollow tube that's inserted into the space just outside the membrane surrounding your spinal cord and spinal fluid. (This is called the epidural space.)
The medication is usually a combination of a local anesthetic and a narcotic. Local anesthetics block sensations of pain, touch, movement, and temperature. Narcotics blunt pain without affecting your ability to move your legs. Used together, these medications provide good pain relief, and you'll lose less sensation in your legs and need a lower total dose than if you had just one or the other.
Learn more about epidurals.
A spinal differs from an epidural in two ways:
- It's delivered directly into the spinal fluid (rather than into the space just outside the membrane that surrounds the spinal fluid), and
- It's a one-time injection rather than a continuous feed through a catheter.
As a result, relief is rapid and complete but lasts only a few hours.
Your practitioner may order a spinal block if:
- you decide you want pain relief late in labor or,
- you're progressing so rapidly that delivery is likely to be relatively soon, and you can't wait for an epidural.
Learn more about spinal blocks for labor pain.
A combined spinal/epidural block offers the rapid pain relief of a spinal block and the continuous relief of an epidural.
You may opt for a combined spinal/epidural so you get immediate relief from the spinal while you're waiting for the epidural to work.
Learn more about the combined spinal/epidural for labor pain.