Ask the Doctor with Dr. Jill Hechtman, M.D., FACOG, Medical Director Tampa Obstetrics
Q: I’m a few months away from delivering my first baby. What are my options for pain control?
There are many different pain management options available for pain management during labor. Some are more effective than others. I like to begin with the option of going natural. There are different methods available such as breathing techniques, hypnosis, massage and the Bradley method that can help you achieve a medicine-free birth process.
IV pain medication is another option. We use medications like Stadol, morphine, Dilauded and Demerol to help with pain control. These medications can make you feel sleepy and sometimes cause nausea and vomiting. Once you are actively changing your cervix, there becomes a point that you can no longer get these medications. That is because they can have effects on the baby.
Local and regional blocks are another alternative. The most common example is the epidural. By far, this is the best and most effective way to control pain in labor. In the past, people thought that it can slow the labor process down, however that has not been proven. Local blocks include pudendal blocks (these are fairly rare) but they can numb the vaginal area as the baby is being delivered.
An old technology is making its way back here also: nitrous oxide or laughing gas. This is the same as the gas often used in dentists’ offices, but we use it in a different concentration. The mother has total control of when she breathes it in and when she wants it. It takes away some of the pain during the contractions, and it is a great option for women who want to go natural but need a little something. You can also get this at the last minute, unlike IV pain medication. There are no deleterious effects on the mom or baby.
It is important to point out that whichever pain management method you choose is okay. You are already a hero for being there and delivering a baby! Talk with your doctor or midwife about what you want. Have that discussion. You may initially want to try going natural, but realize that you need more pain control. That is okay! There also may be a point that your doctor recommends a certain pain medication or epidural.
If you are having a scheduled cesarean section, the most common anesthesia used is a spinal block. This is when they give medication through your back that numbs you from the waist down. It is similar to an epidural, except it is given in one shot and you cannot give continuous meds through it. If you have been laboring and have an epidural in, they can use the epidural during the C-section and give medication through it.
Occasionally, in emergency situations, you may have to have general anesthesia. This is when you go to sleep, and have a breathing tube placed. Medications are given so that you are unaware of what is happening and there is no pain. This is generally reserved for special circumstances.
The goal during the labor and delivery process is a healthy mother and baby. There really is no need to suffer!