Introduction

Many types of medication can ease pain during labor and delivery. Epidural and spinal blocks are common choices — but you have other options, too. Work with your health care team to make the best decision for you and your baby.

Click on the tabs to the left to learn more about specific medications used during labor and delivery.

Epidural block

Description
An epidural block is a regional analgesic or anesthetic that can be used during active labor or shortly before a C-section. The medication is injected into the lower back just outside the bag of fluid surrounding the spinal cord. It takes about 20 minutes to administer an epidural block and another 10 to 20 minutes for the medication to take effect.

Pros
An epidural alleviates most pain in the lower body without significantly slowing labor. It can be used continuously throughout labor. You'll remain awake and alert. A walking epidural — a combination of an epidural and a spinal injection that leaves you enough muscle strength to walk during labor — is available in some facilities. An epidural block usually has little or no effect on the baby.

Cons
An epidural may affect one side of your body more than the other. An epidural may decrease your blood pressure, which can slow the baby's heart rate. Rarely, you may have a severe headache when you're upright in the days after delivery. If the anesthesia affects your chest wall, you may have the temporary sensation of difficulty breathing. Because epidural anesthesia may block the ability to empty your bladder, you may need a catheter. You may also experience soreness at the injection site. You may want another procedure if the epidural doesn't work as well as expected.

Spinal block

Description
Spinal anesthesia is a regional anesthetic used during active labor if delivery is expected within two hours or shortly before a C-section. The medication is injected directly into the fluid surrounding the spinal cord in the lower back and takes effect quickly.

Pros
A spinal block provides complete pain relief from the chest down for up to two hours. The medication is usually given only once. You'll remain awake and alert.

Cons
A spinal block may affect one side of your body more than the other. A spinal block may decrease your blood pressure, which can slow the baby's heart rate. Rarely, you may have a severe headache when you're upright in the days after delivery. If the anesthesia affects your chest wall, you may have the temporary sensation of difficulty breathing. Because spinal anesthesia blocks the ability to empty your bladder, you'll likely need a catheter. You may also experience soreness at the injection site. You may want a repeat spinal block or another procedure if the block doesn't work as well as expected.

Narcotics

Description
Various narcotics may be injected into a muscle in your thigh or buttock or given through an intravenous (IV) catheter. If you have an IV, you may be able to control your dosage. The medication takes effect in minutes.

Pros
Narcotics decrease the perception of pain for two to six hours. They promote rest without causing muscle weakness.

Cons
Narcotics may cause sleepiness and temporarily depress breathing for you or the baby. Your baby may experience temporarily slowed reflexes as well.

Local anesthetic injection

Description
A local anesthetic doesn't help with labor pain but may be used to numb the vaginal area if you need an incision to extend the opening of the vagina (episiotomy) or repair a tear after delivery. The medication is injected into tissue at the vaginal opening and takes effect quickly.

Pros
Local anesthetics temporarily relieve pain in a specific area. Negative effects for mother or baby are rare.

Cons
Local anesthetics don't relieve the pain of contractions. An allergic reaction is possible. Rarely, injecting the medication into a vein may decrease your blood pressure.

Pudendal block

Description
A pudendal block may be used shortly before delivery to block pain between the vagina and anus (perineum). A local anesthetic is injected into the vaginal wall and takes effect in seconds.

Pros
A pudendal block relieves pain in the lower vagina and perineum for up to an hour. Negative effects for mother or baby are rare.

Cons
A pudendal block doesn't stop the pain of contractions. The medication may affect only one side of the perineum. An allergic reaction is possible. Rarely, injecting the medication into a vein may decrease your blood pressure.

Tranquilizers

Description
Rarely, tranquilizers are used to relieve anxiety and promote rest in early labor. They may be given by mouth, injected into a muscle in your thigh or buttock, or given through an intravenous (IV) catheter. When injected or given intravenously, tranquilizers take effect in minutes.

Pros
Tranquilizers relieve anxiety and promote relaxation for several hours or more.

Cons
Tranquilizers don't relieve pain. They may cause drowsiness, decrease your memory of labor, and decrease your baby's muscle tone and activity at birth.