Analgesia and Anesthesia in Labor and Delivery

After many months of waiting for the delivery of your new baby, most women are anxious about the pain they expect to have during childbirth. There are a number of techniques and medications that may help you through the birth process.

The best thing a woman can do during pregnancy is to learn as much as she can about labor and birth. You and your partner can attend childbirth classes, which teach you about childbirth and how to become an active participant in the process. You will learn coping strategies including, breathing and relaxation techniques, position changes, ambulation and water therapy which will help to overcome some of the tension and fear you will feel during labor.

The following methods of pain relief are available to help you through the birth of your baby. Our goals are to help you have a positive experience and to ensure the health and safety of you and your newborn. We encourage you to ask questions of your doctor, nurse midwife or nurse if you have concerns about pain relief.

Narcotics
There are certain types of narcotics which can be given to help reduce pain and anxiety. Nubain and Demerol, which are commonly used, can be given as a shot or through an IV. These drugs can cross the placenta to the baby and may depress breathing after birth for a short while. You and your baby will be carefully watched during the labor and delivery to decrease the chance of this happening and the baby can be given a medication to reverse the effects of the narcotics if this occurs.

Epidural Anesthesia
One type of anesthesia often used during labor is called an epidural. With epidural anesthesia you will be awake and can watch the birth of your baby. You can interact right away with your newborn. An epidural involves medication being injected just outside the spinal canal into the epidural space through a catheter which remains in place until after the delivery. It causes numbness from the waist down and contractions will be less painful.

In order to insert the epidural catheter, an area of the back is numbed. Medication can be given through the epidural catheter during labor and delivery as needed. An IV is started and the mother and baby are monitored continuously. The epidural is put in when the mother is in active labor and can be used for a vaginal or cesarean birth. There are minimal side effects to the baby with this type of pain relief. In some cases an epidural infusion may cause the mother's blood pressure to drop, and this can be reversed with IV fluids and medications. There are a few cases when the epidural cannot be used.

Local
A local, or numbing medicine may be used right before your baby is born if an episiotomy is needed. The medicine is injected into the area where the episiotomy is performed and lasts through the birth of your baby and the repair of the episiotomy.

Pudendal Block
A pudendal block is a type of pain relief that is frequently used just before delivery. A numbing medicine is injected through the vaginal walls to decrease the pain during the birth of your baby. It numbs more area than the local. You will still be able to feel your contractions and this anesthesia does not affect your baby.

Spinal Anesthesia
A spinal is like an epidural in many ways. After a numbing medicine is put in the mother's back, an anesthetic medicine is injected. The tube is not left in place as in an epidural. The spinal lasts for a limited time and because of this, it is usually done shortly before a vaginal, forceps delivery, or a cesarean birth. This type of anesthesia may also, in rare cases, cause the mother's blood pressure to drop, which can be reversed with IV fluids and medication.

General Anesthesia
In some cases, it may be better for the mother to be asleep during the birth and a general anesthesia is used. These include an emergency cesarean, a planned cesarean or a difficult vaginal birth. The delivery must occur quickly because these types of anesthetics can cross the placenta to the baby and may depress breathing in the baby for a short while.

Last Reviewed 2005

Source: Department of Nursing: Children's and Women's Services/OB-GYN Patient Education Committee

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.