As a doula, I help women prepare for labor and delivery - as much as possible. Labor is unpredictable, but we can try to mentally prepare for the unexpected as much as possible. One of the ways you can prepare for childbirth is by knowing our options for treatment - specifically for pain relief. Modern medicine has blessed us with the opportunity to take a pass on labor pain. If you'd like to, take full advantage of those resources! Before you decide what you'd prefer, it's best to research the benefits and risks of each different form of pain relief. Most people know you can get an epidural during labor - that's usually what you hear about in pop culture, too. Luckily, there are so many more options than just an epidural! Not all of them are widespread; some are more commonplace in Europe and are just now catching on in the United States. Make sure to ask which options your birthing center offers during your labor & delivery unit tour!
An epidural is an injection of medication directly into the spinal cord. Sounds pretty hardcore, right? Well, that's because it is! An epidural involves an anesthesiologist who comes to your room, inserts a long needle in between your vertebrae, directly into the dura (the membrane surrounding your spinal cord). Once they pierce that dura, they release a steady dosage of pain medicine directly into the spinal cord. Essentially, that just blocks the communication pathway between your mind and your body. In effect, your body is still experiencing the pain, but your brain can't tell. It's truly magical!
Benefits: Obviously they offer great pain relief! Many times, women who are stalled in labor may make progress after they receive an epidural because their body can relax instead of tensing through the pain. If anyone tries to shame you for wanting pain relief during labor tell them they can buzz right off. It's not just a way to relieve discomfort (which, by the way, is a totally valid reason to use it), it can also lead to a more straightforward birth experience.
Drawbacks: The most obvious downside is immobility. Once you get an epidural you can't feel anything in the lower half of your body; which means you can't walk on your own, can't go to the restroom, and don't know what's going on below decks. Another thing to keep in mind is epidurals aren't perfect every time. You may receive an incomplete epidural, where pain relief is spotty or only impacts one side of the body. Not everyone is a great candidate for an epidural - discuss this with your care provider. A fair number of patients develop a "spinal headache" from leaking cerebral spinal fluid.
Narcotic Pain Relief
This is the option I used during labor with my son. I needed some rest, so my OB recommended I try Dilaudid. It made me loopy and groggy - and I still felt my contractions but they were much much duller. Narcotic pain relievers are typically administered through an IV line during pregnancy.
Benefits: Narcotic pain relief allows for freedom of movement. It's also a great way to provide temporary pain relief! My dose of Dilaudid wore off in about an hour, which meant I wasn't loopy and groggy for the actual moment of birth. I'd argue that a major benefit of narcotic pain relief is that it doesn't require any spinal involvement, so it's a bit less intimidating.
Drawbacks: Narcotic pain relief isn't safe for all people, so some cannot use it - even in labor. Anyone who hs a history of addiction might also want to steer clear, especially if they've been addicted to opiates. While labor pain might be unpleasant, a potential relapse is far worse. Note that if narcotics are administered within two hours of birth, a pediatric respiratory specialist may be called in to check on the baby. This is because narcotic pain relief can depress respiration, making it harder for mother and baby to breathe properly.
This type of pain relief is inhaled through a mask, making it self-administered. Popular in the UK, where it's called "gas and air", nitrous oxide isn't widely available in the United States. More and more hospitals are offering it, so check with yours to see if they've added it to their options! Known in the U.S. as "laughing gas", nitrous oxide makes you feel a bit loopy and giggly. That's a huge improvement from the discomfort of labor!
Benefits: Since it is self-administered, nitrous oxide gives laboring women a sense of control over what can otherwise be an unpredictable experience. It only needs to be used during contractions, so the sensation of being light-headed or "goofy" passes very quickly after the mask is removed. Because the tank can be moved from place to place, nitrous oxide also provides freedom of movement.
Drawbacks: The only real drawbacks involve overdosing on nitrous oxide - which would have to be a pretty determined patient! Really, though - it can cause dizziness, nausea, and vomiting. Again, these symptoms subside rather quickly when the patient stops inhaling the gases.
I'm including water birth because it has been proven to reduce pain levels in laboring women. While laboring in water is not a drug, it is still an option that isn't exactly commonplace in a hospital setting. Immersing in water reduces blood pressure and relaxes the laboring mother, which in turn allows endorphins to flow freely. Endorphins reduce pain by blocking the absorption of pain-causing hormones like cortisol.
Benefits: Pain relief, increased privacy, and reduced pressure. Buoyancy helps reduce pressure on joints and possibly ease the stretching of the perineum. Additionally, the buoyancy provided by water makes it easier to move freely and choose a comfortable position for birth.
Drawbacks: The only drawbacks to water birth are largely hypothetical. Two European medical journals have cited an extremely slim possibility for the mother to experience a water embolism, or for the baby to prematurely inhale and aspirate water. Otherwise, water birth is only contraindicated if you have certain conditions like bleeding disorders or pre-eclampsia.
There is no wrong way to birth. If you choose to have an epidural, a scheduled c-section, or to birth at home in your bed - you are amazing! There is no shame in wanting or needing pain relief. Lucky for laboring women, modern medicine has given us so many options!
Did you choose to use pain relief during labor? What was your experience with it? Share your story with me on Twitter @pi3sugarpi3 with #LaborPains.