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Labor pain: Weigh your options for relief

By Mayo Clinic staff
Original Article:  http://www.mayoclinic.com/health/labor-pain/PR00065
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Labor pain: Weigh your options for relief

Labor pain on your mind? Understanding pain relief options can give you more control over the labor and delivery process.

By Mayo Clinic staff

Labor is a natural — although challenging — process. No two women have the same degree of labor pain, and no two labors are exactly alike. Ultimately, you need to choose the pain relief option that's right for you.

The best approach to labor pain relief depends on your preferences and on how your labor progresses. Sometimes, you won't know what kind of pain relief you want until you're in labor. Still, it's a good idea to think about your options for managing labor pain ahead of time. Find out what's available at your hospital or birthing center, and discuss your preferences with your health care provider.

Consider the options

There are many ways to ease and control labor pain. Relaxation exercises, breathing techniques and frequent changes of position often help — particularly in the early stages of labor. Your partner or labor coach can massage or firmly press on your lower back, or apply ice packs or heat to your lower back. Other options include playing music and taking a shower or bath.

As labor progresses — and contractions become stronger and more frequent — many women add medication to their arsenal of pain relief options. Epidural and spinal blocks, for instance, temporarily block pain in the lower body. An epidural can be used continuously throughout labor, while a spinal block is typically used shortly before delivery. Alternatively, narcotics or other medications can be used to alter pain perception.

Nontraditional options for managing labor pain might include hypnosis, acupuncture, water immersion or reflexology. These techniques won't stop the pain of contractions, but they might help you feel more relaxed and better able to handle labor pain.

Understand the pros and cons

Each pain management option has pros and cons. Relaxation and breathing techniques can distract you and help you feel a better sense of control, but they might not dull the pain. Medication can make contractions less painful, but you might experience side effects — such as drowsiness, nausea or itchiness. With some medications, you might be restricted to bed or to a specific position, and your bladder might need to be emptied by a catheter. Some medications can affect your baby, too. If you're given systemic analgesics shortly before delivery, for instance, your newborn could experience temporary breathing problems or slowed reflexes.

Expect the unexpected

Labor and delivery are unpredictable. Labor pain might be more intense than you expected, or it might hurt in a different way. Even if you have a plan for managing labor pain, you might decide to change it as labor progresses — or the specific characteristics of your labor might prompt your health care provider to suggest a pain relief option that wasn't in your original plan. Keep in mind that birth isn't a test of endurance. You won't have failed if you ask for pain relief.

One thing is certain: The more you learn about options for managing labor pain, the more prepared you'll be to handle labor — however it unfolds.

Things to consider before you choose

So what's the bottom line on managing labor pain? Think about what appeals to you most, and ask your health care provider these questions:

  • What's involved in the method?
  • How will it affect me? Will I be able to walk, or will I be confined to bed?
  • How will it affect my baby?
  • What are the possible side effects?
  • How quickly will it work?
  • How long will the pain relief last?
  • Can I combine it with other methods of pain relief?
  • When during labor is the method available?
  • What if it doesn't work?
  • Will I remember everything?
  • Will I be able to breast-feed my baby after delivery?

Talk to your labor partner about your plan for pain relief before you go into labor. Review your plan with your health care team when you arrive at the hospital or birthing center to give birth. Remember, you're free to request pain relief at any point during labor and delivery. Trust your health care team to provide you with information about your options as your labor progresses — and trust yourself to make your own choices when it comes to pain management.

References
  1. Q&A: Pain management during childbirth. American Society of Anesthesiologists. http://www.lifelinetomodernmedicine.com/Anesthesia-Topics/QA-Pain-Management-During-Childbirth.aspx. Accessed March 31, 2011.
  2. Grant GJ. Neuraxial analgesia and anesthesia for labor and delivery: Drugs. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  3. Anesthesia options for labor and delivery: What every expectant mother should know. American Association of Nurse Anesthetists. http://www.aana.com/ForPatients.aspx?ucNavMenu_TSMenuTargetID=68&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=291&terms=anesthesia+options+for+labor+and+delivery. Accessed March 31, 2011.
  4. Grant GJ. Adverse effects of neuraxial analgesia and anesthesia for obstetrics. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  5. Misconceptions about labor and delivery. American Society of Anesthesiologists. http://www.lifelinetomodernmedicine.com/Anesthesia-Topics/Misconceptions-About-Labor-and-Delivery.aspx. Accessed March 31, 2011.
  6. Types of pain relief in labor and delivery. American Society of Anesthesiologists. http://www.lifelinetomodernmedicine.com/Anesthesia-Topics/Types-of-Pain-Relief-in-Labor-and-Delivery.aspx. Accessed March 31, 2011.
  7. Grant GJ. Neuraxial analgesia and anesthesia for labor and delivery: Options. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  8. Simkin P, et al. Nonpharmacological approaches to management of labor pain. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  9. Grant GJ. Pharmacologic management of pain during labor and delivery. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  10. Lothian JA. Preparation for labor and childbirth. http://www.uptodate.com/home/index.html. Accessed June 3, 2011.
  11. Pain relief during labor and delivery. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp086.cfm. Accessed March 31, 2011.
  12. Hawkins JL, et al. Obstetric anesthesia. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Elsevier Inc.; 2007. http://www.mdconsult.com/books/pdf/978-0-443-06930-7/4-u1.0-B978-0-443-06930-7..50018-9..DOCPDF.pdf?isbn=978-0-443-06930-7&eid=4-u1.0-B978-0-443-06930-7..50018-9..DOCPDF. Accessed May 13, 2011.
  13. Volmanen P, et al. Alternative to neuraxial analgesia for labor. Current Opinion in Anaesthesiology. 2011;24:235.
PR00065 July 22, 2011

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