Pain Control For Labour And Delivery
This will only sting for a minute...
First, I think we need to remember that child birth is not an illness. We often treat it as such, but your body and your baby are made to mold and adjust to each other for a common goal. Even though that common goal sends some of us reeling, your mental approach to each contraction and each pain must be considered natural and expected, even though it is outside of your control.
How you decide to manage your pain may be dictated by where you choose to deliver your baby. Are you going to a hospital with the latest technology and equipment, or to a birthing center where families are encouraged to help and participate? Perhaps you may even be considering a home birth with little or no medical intervention at all. If you head for the hospital, you will be allowed to use a variety of pain control options ranging from some very natural, to some that are very invasive. Birthing centers typically do not offer invasive pain control (like with the use of the epidural) and most women choose this option if they are okay with other methods. If you have concerns, talk with your midwife or doctor and discuss what setting may be right for you. If you are interested in natural pain control methods, you can read up on drug-free births here.
IV or Intramuscular Pain MedicationsIntravenous pain medications will be approached differently depending on where you are. Given into the IV line in your arm or hand, these medications are used to ease the pain of labour contractions and may be administered every few hours for pain relief.
The type of medication used will vary between doctors, but the most commonly used medications include Morphine, a powerful narcotic in combination with a low dose of Phenergan, which is used to treat nausea. These two are often given together due to the increased risk of nausea and vomiting from the strong narcotics. Another commonly used medication is Stadol (butorphanol tartrate) has been used for decades to help moms cope with and manage labour pain.
That said, some women find IV medications to be very effective, while others report feeling "drunk" and having contractions that continue with no relief. While relatively safe for both mom and baby, you may choose this method of pain control in an attempt to avoid or put off an epidural. It might work well - then again, it might not. So proceed with caution here.
Many of the same medications may be given by injection with a needle into the muscles of the upper buttocks for a slower onset and absorption rate. Higher doses of pain medication are usually required to achieve the same effect as the IV route, and while this method is still available, it is used less frequently.
Epidurals and Spinal BlocksThe most invasive form of pain control and arguably the most effective is the epidural. Saving you a long anatomy lesson, epidural pain medication must be inserted by an anesthesiologist into the epidural space of the vertebrae in the back. A thin plastic catheter (or tube) is inserted into the space and medications may be introduced and the catheter may be left in place with tape and the end of the tube attached to a controlled, locked pump that holds more medication. This pump can be adjusted up or down depending on your response to the medication. If it's too much, it may be turned down and allowed to wear off (as is common when it's time to push and you can't feel anything) or if you continue to feel painful contractions despite the current rate of pain medication. Pain medications that are placed this way often provide complete anesthesia and can make mom very happy.
Spinals or spinal blocks are essentially placed the same way, however once the correct space is accessed by anesthesia, a dose of pain medication is introduced into the spinal column, where it will circulate as a one-time dose. This medication often lasts a few hours, and numbs so thoroughly that you won't be able to even feel much pressure or movement, as you might be able to with an epidural. Spinals are often used for Cesarean Sections if no other pain control method is in place.
In their attempt to find the best of both worlds, some women may ask for a walking epidural. Used far less than traditional epidurals, don't let the name fool you. Almost half of all women who get one, never take a step out of the bed. A walking epidural uses a different combination of anesthetic "cocktail" that usually contains the anesthetic, a narcotic, and epinephrine. Used in a lower dose for the walking epidural, it is supposed to offer you the chance to still move and feel contractions at the same time - but just take the edge off. A lot of women complain that the walking epidural still makes their legs feel too numb, they may have blood pressure drops, or are simply restricted by hospital safety policies and are not allowed out of bed after the procedure.
However, moms who choose the epidural for pain control are facing many unknowns. Occasionally, there are risks that can develop including a dramatic drop in blood pressure, spinal headaches, blood clots at the needle site in the back, as well as shifts in your baby's heart rate that may send you on the fast track to a Cesarean Section. Moms who have hopes of walking or delivering in a position other than on their back will not want to choose this method because of the need for increased monitoring of both mom and baby, and being numb eliminates the ability to walk or even move. Some hospitals may offer alternative birthing methods like squatting or the modified throne position for labour.
Read & Learn More:
Sober Mama: Having a Drug-Free Delivery
The Needle's Edge - A Breakdown of Prenatal Testing
When To Call The Doctor - Things You Shouldn't Ignore During Your Pregnancy