The choice in pain relief is yours

Each woman's labor is unique to her. Long before labor begins, you should at least familiarize yourself with pain relief options available during childbirth. Consider attending one of several childbirth preparation classes, including a pain relief class offered by the department of anesthesiology, natural childbirth classes, vaginal birth after cesarean (VBAC) classes and others to learn more.
Class listing

It's your decision
The amount of labor pain you feel will differ from that felt by other women in labor. It depends on factors such as your level of pain tolerance, the size and position of the baby, strength of uterine contractions and prior birth experiences.

Some women achieve adequate pain control with the breathing and relaxation techniques learned at childbirth classes and supportive measures provided by labor and delivery nurses. Others choose pain relief during labor and delivery to help them experience a more comfortable childbirth.

Intravenous pain relief
You may receive intravenous (IV) medications to relieve pain, as prescribed by your midwife or obstetrician. These medications are injected into a vein. Because they sometimes make both you and your baby sleepy, they are used mainly during early labor.

Regional analgesia
Regional analgesia can also reduce the discomfort of labor.

Epidural blocks
Epidural blocks are administered in the lower back by an anesthesiologist to "block" pain sensations over a wider region of the body. Epidural analgesia may be used for labor and vaginal delivery.

If you request an epidural, your obstetrician and anesthesiologist will evaluate you and your baby taking into account your state of health and past anesthetic experiences, the progress of labor and your baby's responses. The epidural catheter is then placed into your lower back to allow continuous administration of medication for pain relief during your labor and delivery.

Throughout the procedure, your anesthesiologist carefully evaluates your condition, makes medical judgments, takes safety precautions and provides treatment.

Questions frequently asked about epidurals
1. How soon does the epidural block take effect?
After your epidural catheter is in place, the medication needs to be absorbed into several nerves, thus, the onset is gradual, not immediate. Pain relief will begin to occur within 10 to 20 minutes after the medication has been injected.

2. What will I feel after the block takes effect?
Although significant pain relief will occur, you still will be aware of pressure with contractions.

3. Will the epidural block affect my baby?
Research has shown that epidural analgesia can be safe for both mother and baby, with little or no effect on the infant.

4. Will it slow down my labor?
Each mother may respond differently to various epidural medications. Some may have a brief period of decreased uterine contractions. Most, however, are pleasantly surprised to learn that after the epidural medications have made them more comfortable and relaxed, their labor may actually progress faster.

5. Can I "push" when needed?
Yes.

6. Will an epidural cause me to need a cesarean delivery?
There is no difference in cesarean delivery rates between women who have epidurals and those receiving IV pain medications.

7. What are the risks of an epidural?
Although not common, complications or side effects can occur, even though you are monitored carefully and your anesthesiologists take special precautions to avoid them. To help prevent a decrease in blood pressure, fluids will be administered intravenously (into one of your veins prior to and while receiving epidural medication). Shivering may occur and is a common reaction. Although uncommon, a headache may develop following the block procedure. By holding as still as possible while the needle is placed, you help to decrease the likelihood of a headache. The discomfort, sometimes lasting a few days, often can be reduced or eliminated by simple measures such as lying flat, drinking fluids and taking pain tablets. Occasionally, a patient may need additional treatment.

The veins located in the epidural space become swollen during pregnancy. There is the risk that the anesthetic medication could be injected into one of them. To recognize this, your anesthesiologist will first administer a test dose of medication and you may be asked if you notice any dizziness, a funny taste, rapid heartbeat or numbness.

Last revised: Feb. 8, 2007 (dh)

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All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.