Delivery: What About the Pain?
Pain levels during delivery vary from one woman to another. For some, the process can be very painful, but women can often turn to relaxation and breathing techniques (taught in their childbirth classes) to help them deal with the discomfort. Massage on the lower back by a spouse or other labor coach often eases discomfort as well, as does taking a bath or shower (if allowed) or applying ice packs to the back.
If an episiotomy (surgical incision in vaginal area) is needed to ease the baby’s head through the birth canal, a local anesthetic is injected ahead of time to make the area numb. Local anesthetics given in this manner almost never have any negative effects upon the baby.
As labor progresses, many women decide to have medication to ease the pain of the contractions. These include:
Narcotic (opioid) medications given as a shot or through an intravenous catheter. These medications make the labor pains more tolerable but can slow the baby’s breathing if given very close to delivery.
Numbing medicines given in the spinal region to reduce the intensity of the contractions. This is generally referred to as epidural analgesia or an epidural block. A small tube called a catheter is placed into the epidural space, an area just outside of the spinal cord region. Medicines are then given through this catheter to decrease the feeling in your abdomen and make the contractions less painful. Pain relief generally begins within ten to twenty minutes. Most of the time these medications are given in small enough doses so that you are still alert, aware of the contractions (though they are not as painful), and still have enough strength to push the baby down the birth canal. Side effects or complications are rare, but may include headaches or a drop in your blood pressure.
If your doctor decides that a Cesarean section is necessary, there are three options for pain relief/anesthesia:
Additional numbing medicine can be given through an epidural catheter to make your entire lower body numb ( from below your rib cage to your toes). If you already had an epidural catheter placed to ease the labor pain, then extra medicine can be given through this catheter to make you numb enough for surgery. The advantage of this type of anesthesia is that the baby will not be as sleepy and you can be awake when the baby is born.
If you are having a scheduled Cesarean section, your doctor may recommend a spinal block. This is a single injection into the fluid surrounding the spinal cord. Spinal blocks are very quick and easy to perform and generally make you even more numb than an epidural block. Pain relief begins immediately. One difference between a spinal and an epidural block is that a spinal is a one-time shot of pain medication that wears off on its own in several hours, instead of being administered continuously through a catheter. Side effects or complications are rare, but are similar to an epidural.
If the surgery needs to be performed as an emergency or you have a medical issue that would make an epidural or spinal block dangerous for you, medicines can be given that will make you lose consciousness or “go to sleep” (general anesthesia). This can make the baby very sleepy when he/she is born and affect the baby’s breathing. When general anesthesia is given, the baby must be delivered very quickly in order to decrease these effects, so epidural or spinal blocks are preferred when possible.
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- Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.