Pain Relief Medications During Labor
Pain during labor is one of the most severe pains that humans experience. Fear of labor pain is one of the main reasons that push women to go for the cesarean section.
Labor pain is caused by contractions of the muscles of the uterus and by pressure on the cervix. Pressure on the bladder and bowels by the baby’s head and the stretching of the birth canal and vagina are the other causes of pain during labor. This pain may be felt as strong cramping in the abdomen, groin, and back, as well as an achy feeling.
Pain varies widely from woman to woman and even from pregnancy to pregnancy. The amount of pain felt during labor is different for every woman. The intensity of the pain depends on several factors, such as the size of the baby, the position of the baby, the woman’s pain tolerance level, and the strength of her contractions.
A variety of pain-relief medications can be used during labor depending on the situation. All pregnant women should discuss with their doctor or OB/GYN about the choice of pain-relief medicines well before labor begins. This will help them understand the options, risks, and benefits of different pain relief medications during labor and delivery.
The following are the choices of pain-relief medications are available: Analgesics and anesthetics.
Analgesics provide pain relief without causing total loss of feeling or muscle movement.
- Systemic analgesics
These medications affect the whole nervous system and reduce your awareness of pain. These medications will not cause the patient to lose consciousness. Systemic analgesics usually are injected into a muscle or vein. They can also be inhaled or breathed in with a mixture of oxygen.
- Regional analgesics
These medications provide pain relief in one region of the body. These drugs relieve pain by making a specific part of the body numb. This is called regional analgesia. Regional analgesia is the most used method of pain relief during labor.
The following are the different methods of regional analgesia:
- Epidural Block: Also called epidural analgesia, this makes your lower body numb (loss of feeling) while you stay awake. The medication starts working about 10-20 minutes after it is administered. Your doctor or OB/GYN injects the drug near the spinal cord. A catheter (a small tube) is placed through the needle. The needle is then withdrawn, but the catheter (small tube) stays in place. Small amounts of the drug are given through the catheter throughout labor without the need for another injection.
Spinal Block: Also called a sub-arachnoid block, your doctor or OB/GYN gives an injection of a much smaller amount of the drug into the sac of spinal fluid around the spine. This drug starts working immediately, but it lasts for only 1 to 2 hours. A spinal block is given only once during labor to help with pain during delivery.
Combined Spinal-Epidural Block: Also called a walking epidural, this gives the benefits of an epidural block and a spinal block. The spinal block relieves pain immediately. The epidural block allows drugs to be given throughout labor. Sometimes, a woman can walk around after a combined spinal-epidural block.
Anesthetics block nerve transmission to pain centers, resulting in blocking the feeling of pain.
- General Anesthesia: General anesthesia makes the patient unconscious and the patient does not feel pain while unconscious. It means you are not awake and you do not feel pain. This is used only in emergency situations during childbirth. An anesthetic drug is given through an IV line or through a mask. After you are asleep, your anesthesiologist will place a breathing tube into your mouth and windpipe.
- Local Anesthesia: Local anesthesia blocks sensation in a region of the body. Local anesthesia removes all feelings, including pain, from a specific part of the body while the patient stays awake. Your doctor injects the anesthetic drug into the area around the nerves that transmit feeling to the Cervix, vagina, vulva, and perineum. The anesthetic drug is given just before delivery to relieve pain during childbirth.