The management of pain during labor varies greatly. It is important for you to talk with your doctor before labor begins, and choose the pain relief methods that are best for you. Natural childbirth (no medication), regional anesthesia and intravenous medications are the methods most commonly used today. These are not the only options, however. Local anesthesia and pain blocks are also frequently used at different stages during labor and delivery. General anesthesia with or without inhaled gases can also be used safely in labor, though, they are often reserved for specific indications.
Natural childbirth with no medication is an option for women having their first baby if they are very well motivated and are able to apply other pain relief methods such a rhythmic breathing, meditation, and biofeedback. For women who have already delivered a child, this process is often easier and quicker the second time and natural childbirth is more realistic. The of Obstetricians and Gynecologists state that any women having labor pain should be offered pain relief.
During labor, intravenous narcotics and epidural anesthesia are the most commonly used methods. Intravenous narcotics have the side effect of causing some depression of the baby and can make certain fetal heart rate patterns more difficult to interpret. Epidural anesthesia can have the bothersome side effect of lower extremity numbness, though, nowadays medications are being adjusted to allow for pain control without excessive temporary paralysis. For cesarean sections the preferred method of pain control is spinal anesthesia, which is similar to an epidural except that the length of regional anesthesia is fixed and wears off after several hours.
During delivery, if an epidural has been placed it can be used for delivery as well. If an epidural is not in place or is not adequate, local anesthesia can be used to numb areas of the birth canal. A special type of regional anesthesia, called a pudendal block, is placed transvaginally by the obstetrician and can numb all the pelvic tissues at one time.
There are many very excellent options for pain relief during labor and even women with complicated medical conditions can usually be relieved of their labor pain with one of several methods. In this day and age, no women should have to go through labor with unwanted pain. With more advanced techniques, such as combined spinal/epidural anesthesia, even women presenting very close to delivery can have their pain adequately controlled.
The Pain Relief In Labor HealthMap will describe in detail all the choices available.