The goal of natural childbirth classes is to prepare couples with non-medicinal coping tools that can provide powerful pain relief during labor.  But what if you experience an abnormally long or complicated labor?  A challenging labor may bring you to the point where your coping reserves feel tapped, and you may benefit from some additional help.  In cases like this, pain medications can be a useful option to provide additional pain relief during labor. Let’s discuss the most common medicinal options for pain relief during labor — anesthesia and analgesics.  We’ll also highlight the main pros and cons of each pain medication option.

Estimated reading time: 4 minutes

Anesthesia Pain Relief During Labor

Anesthesia is the most common medicinal pain relief during labor.  It causes a temporary loss of sensation produced by injecting an anesthetic medication into an area around the nerves.  The most widely used anesthesia in labor is is an epidural, where the medication is injected into the epidural space of the spine.  According to a recent survey, 62% of women use epidurals for pain relief during their vaginal birth (2).

Pros of Anesthesia

• Epidurals can completely block the painful sensation of a contraction (3).
• At the same time, mom can remain awake and alert to experience the labor and birth of the baby (4).
• Epidural medication can have less negative side effects on baby than other pain medication options.

Cons of Anesthesia

• There’s no guarantee that an epidural will work perfectly.  Some women still feel pain in parts of their uterus even though other parts of their body are numb.
• Epidural medication can frequently cause episodes of low blood pressure (1).
• The use of epidural medication is associated with a longer pushing phase and a higher rate of assisted deliveries (5).
• Less common epidural side effects include itching, maternal fevers, severe headaches, and even nerve damage (1).

Analgesic Pain Relief During Labor

Analgesics are medications that decrease mom’s sensation of labor pain.  These include narcotics such as Fentanyl, Demerol, and Stadol.  They’re often administered through an IV, and sometimes through a shot in the muscle.  Analgesics don’t actually get rid of the pain of the contraction.  Instead, they create a state of sedation and euphoria, such that moms just tend to care less that they’re having a contraction.  About 16% of women use narcotic analgesics for pain relief during their vaginal births (2).

Pros of Analgesics

• Sometimes analgesics can help mom get over the “hump” of a difficult labor, allowing her to relax completely in between contractions (6).
• Analgesics can be administered quickly, offering rapid pain relief (4).
• Analgesic don’t directly interfere with mom’s ability to push.

Cons of Analgesics

• Narcotic analgesics can have serious side effects on mom, including a reduction in blood pressure and respiratory rate.  Moms can also feel grogginess, itching, nausea, and dizziness (7).
• Analgesics used in labor cross the placenta, and thus baby directly receives the medication that mom receives.
• The use of analgesics is associated with negative effects on the baby’s heart rate, lower Apgar scores, and respiratory depression at birth (8).

The Takeaway:

Childbirth is an exciting, challenging, and occasionally an overwhelming physical and emotional experience.  It’s wise to prepare yourself beforehand with a wide variety of non-medicinal coping tools that you can use to help promote a safe and satisfying birth.  Additionally, take the time during your pregnancy to explore the pain medication options that are available to you, in case additional pain relief during labor becomes necessary.  This preparation will empower you with the knowledge to approach your birth with calm and confidence, no matter how the experience plays out.

Kopa Birth’s online birthing classes allow you to prepare for natural childbirth in the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for natural childbirth. 

References:

1. Olds, S.B., London, M.L., & Ladewig, P.W.  (2000).  Maternal-newborn nursing:  A family and community-based approach.  Upper Saddle River, NJ:  Prentice Hall Health.
2. Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Listening to MothersSM III: Pregnancy and Birth. New York: Childbirth Connection, May 2013.
3. Arim-Somuah, M. Smyth, Rl, Jones, L.  (2011).  Epidural versus non-epidural or no analgesia in labour.  Cochran Database Sys Rev 12:  CD000331
4. Nichols, F.H., & Humenick, S.S. (2000).  Childbirth education:  Practice, research and theory.  Philadelphia:  Saunders.
5. Allen, V.M., Baskett, T.F., O’Connel, C.M., McKeen, Dl, Allen, A.C.  (2009).  Maternal and perinatal outcomes with increasing duration of the second stage of labor.  Obstet Gynecol 113: 1248-1258.
6. Simkin, P.  (2010).  Pregnancy, childbirth, and the newborn:  The complete guide.  Minnetonka, MN:  Meadowbrook Press.
7. Hawkins, J. & Bucklin, B.  (2010).  Obstetrical anesthesia.  In Gabbe, Sl, Niebyl, J., & Simpson, J. (Eds.), Obstetrics:  Normal and problem pregnancies (6th edition).  Philadelphia:  Saunders.
8. Sekhavat, L. & Behdad, S. (2009).  The Effects of Meperidine Analgesia during Labor on Fetal Heart Rate.  International Journal of Biomedical Science:  IJBS, 5(1), 59-62.

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