Pain Management During Labor

Jessica Evert, MD, edited by Benjamin McDonald, MD

woman breathing deeplyIf you're like most women, the pain of labor and delivery is not something to which you are looking forward. Though some women do experience little pain during labor, they are a minority. Most women experience labor as a painful process. For this reason, it is important to educate yourself about your options for pain management during labor, and to decide which methods will best fit your needs. Keep in mind that your best bet is to be well informed and flexible in your options because you won’t know how painful labor will be until you actually experience it. Work with your doctor or midwife to decide which types of pain relief you are interested in, so that there is no confusion once you are in labor!

Listed below are various methods, some common and some lesser-known that can help reduce pain during labor:

  • The Lamaze Technique. Lamaze emphasizes the use of breathing exercises, distraction methods, and relaxation techniques for pain management rather than pain medication. This approach to pain management focuses on the idea that giving birth is a normal, healthy part of life, and that a woman should approach the experience with confidence. Lamaze classes are usually available at hospitals; ask your doctor about classes in your area. Information on Lamaze is available online here.
  • The Bradley Method. Like Lamaze, the Bradley Method is a more natural approach to pain management that does not depend on the use of medications. Women are encouraged to maintain good nutrition and to exercise throughout pregnancy to prepare for labor. During labor, proponents of the Bradley Method focus on deep breathing and relaxation techniques to help with pain. The participation of a partner or coach is a very important part of this technique. Bradley classes are offered nationwide. Information on the Bradley Method is available online here.
  • Acupuncture. A technique drawn from traditional Chinese medicine, acupuncture involves the placement of small needles into certain points on your body. Though the mechanism is not well understood in western scientific terms, an easing of the pain of contractions can occur.
  • Transcutaneous Electric Nerve Stimulation (TENS). The TENS method involves the application of mild electric impulses to points on your body so as to block pain impulses and stimulate alternative nervous pathways.
  • Massage. Massage of the lower back, feet, and other areas can bring about relaxation and mild pain relief.
  • Warm Water Tub. Some women opt to go through the initial stages of active labor in a warm water bath which can be comforting and relaxing. Note that a warm water bath is not the same thing as a hot tub, which may be dangerous for the baby!
  • Sedative Medications. Sedative medications help a woman to relax and can relieve nausea and vomiting. These medications are commonly used during the first stage of labor.
  • Narcotic Medications. Narcotic medicines such as Fentanyl, Demerol, and Morphine do not generally ease the pain of labor, but do reduce anxiety and can make labor easier. These medications affect the whole body, and can therefore cause drowsiness.
  • Regional anesthesia. Regional anesthesia, for example, the epidural block (or "epidural" as it is commonly known) involves an injection of pain relieving medicine into the lower back. This medicine directly shuts down the nerves that transmit pain signals to the brain, and thus prevents the brain from feeling the pain associated with labor. Woman who have received an epidural commonly will feel numb from the waist down. An epidural is given when a woman enters active labor (labor phase one, stage two, as described below). The amount of medication can be increased or decreased by the administering doctor according to each woman's needs. You should speak to your health care provider in advance of your labor if you wish to have an epidural or similar pain treatment while giving birth.



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