Drugs for Labor Pain
I'm scared of labor. What
can I take for the pain? Fortunately, you can do a lot to ease the
pain. First be aware that the more you can relax, the less pain you'll feel.
That said, many women find this information fairly useless. Still, it can't hurt
to study up on
No one finds the experience easy--it isn't called labor for nothing--but the
intensity of the discomfort ranges widely from woman to woman and birth to
birth.
Finally, there are a variety of medications that will dull the pain.
What drugs are available? Systemic medications, such as Demerol, can
cause a variety of side effects, such as drowsiness, dizziness, nausea, and
disorientation. Since they cross the
Dozens of medications, divided into two broad categories, will take the edge off
labor pains: systemic medications, which relax you, and regional analgesics,
which reduce pain only in specific parts of your body.
Systemic medications
Systemic medications are sedatives, tranquilizers, and narcotics. They are most
often given as injections or added to an intravenous (IV) line, entering your
bloodstream and affecting your entire body.
Regional analgesics
Regional analgesics, such as epidurals and spinal blocks, reduce sensation in
specific parts of the body. They allow you to stay awake and participate in
labor and birth without feeling pain. The medication generally doesn't affect
the
fetus directly. However, in most cases, regional analgesics prevent you
from standing up and both you and the baby will require more monitoring devices
once you've taken the drug.
What's an epidural? Advantages:
• The pain relief will last
throughout your labor.
• The anesthetist can control the
effects by adjusting the type and strength of the medication.
• You will be awake and alert during
labor and can rest during dilation, which means you may have more energy when it
comes time to push the baby out.
Disadvantages:
• You have to stay in an awkward
position for five to ten minutes, then wait another ten to 20 minutes before the
medication takes full effect.
• The loss of sensation may make it
harder to push the baby out.
• You may get only spotty pain
relief.
• The drug may temporarily lower your
blood pressure, resulting in decreased blood flow to your baby, slowing his
heart. (This is treated with fluids and medication.)
• In less than 2 percent of cases, an
epidural results in a bad headache. More rarely, it causes nerve injury or
infection. * Some studies suggest that women who use epidurals are more likely
to need a
An epidural block is a kind of regional analgesic. An anesthesiologist or
nurse-anesthetist injects the drug into the space just outside the dura--the sac
membrane that surrounds the spine. You lie curled on your side, or sit on the
edge of the bed for the injection. The anesthetist passes a catheter, a very
thin, flexible hollow tube, through the needle, then withdraws it and tapes the
catheter in place so he can add medication through it as needed.
Advantages:
• Pain relief is rapid.
Disadvantages:
• You have to hold an awkward position for five to ten minutes while being injected.
• The loss of sensation may make it harder to push the baby out.
• In rare cases, the drug may temporarily lower your blood pressure, resulting in temporary decreased blood flow to your baby, slowing his heart. (This is treated with fluids and medication.)
• In about 1 percent of cases, using the drug results in a bad headache. Even more rarely, it results in nerve injury or infection.
Tell me about a combined spinal/epidural block.
A combined spinal/epidural block is a relatively new technique that offers the
rapid pain relief of a spinal combined with the continuous relief of the
epidural. In early labor this technique allows you to stand more easily than
with either a spinal block or an epidural alone. That's because the medication
is mostly narcotic, so you're less weak or numb. For this reason, a combined
spinal/epidural block is sometimes known as a "walking epidural."
Because the drugs go directly into your spinal fluid, they won't affect the
baby.
Will I have to go under general anesthesia if I have a
c-section?
Probably not. If your c-section is planned you'll most likely have an
epidural. Only if you need an emergency
cesarean section may general
anesthesia be called for. If so, you'll lose consciousness by breathing in drugs
through a tube put down your trachea (windpipe).