What Kind Of Pain Relief Shall I Use?

February 4, 2009

Do Your Research Before Going Into Labor

Today's options for medication to deal with the pain during labor and delivery are myriad. It is important for a woman to discuss her options with her obstetrician and anesthesiologist to determine a course of pain relief before she actually goes into labor. The quality of labor and childbirth are not contingent upon the type of medication used, or whether it is used at all. All medications affect both labor and the baby in some way so it is important that careful monitoring be done to ensure side effects are kept to a minimum.

The decision as to which medication to use will be determined based upon individual needs. Along with the medication suggestions, the doctors will also advise alternative pain relief measures. If there will be a labor partner, it is important for that person to know how far into labor the woman is and whether she will be able to handle the labor without medications by using breathing techniques, rest and coaching.

Use Of Narcotic Pain Relievers for Labor Pain

Unless there is a medical reason for a woman to have heavy medications, most often pain relievers can be administered and labor can proceed successfully through delivery. Morphine, Fentanyl, Nubain or Stadol are all narcotic pain relievers which are given early in active labor either by IV or intramuscular injection. They are not considered harmful to the mother or baby when given at the proper time and dosage and they help to take the edge off the pain. The side effects are sleepiness, sometimes a feeling of nausea and the mother may feel less in control. If morphine is given, the baby can experience respiratory depression which can be reversed with the administration of Narcan. Morphine can also cause the baby temporary difficulty with breastfeeding.

When The Pain Is Stronger

Regional anesthesia can be diluted local anesthetics, a combination of narcotics and local anesthetics or a more concentrated local anesthestic alone. Regional anesthesia includes intrathecal injection of a narcotic or local anesthetic into the central spinal fluid by needle. This is used when labor pain is not relieved by other methods. It is fast, effective and does not alter pushing efforts. However, it lasts only a short time. A walking epidural is administered through a needle in a catheter in the epidural space. It usually gives fast and effective pain relief for early labor. Some risks include a drop in blood pressure, a possible decrease in pushing ability, restriction of mobility and possible risk of infection.

Free From Labor Pain And Awake For The Birth!

A local anesthetic epidural is given as labor progresses from active to transitional labor and is usually administered as a continuous infusion via a control pump. Labor can be shortened as the mother relaxes and the mother can usually push with help. Pain relief is such that a mother can stay awake during a Caesarean delivery even though there is a total blockage of sensation. As with a walking epidural, there can be a drop in blood pressure and the mother is confined to bed. Since sensation is diminished, a vacuum or forceps delivery may be necessary as the pushing efforts wane.

There are also local blocks and Caesarean medications which we haven't addressed here. They are used when forceps, vacuum extractors, emergency Caesarean or episiotomy are necessary.

 

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