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Labor Pain Options

Know your labor pain options, so when it’s time to deliver you can choose what makes sense for you with confidence.

Natural (non-medicated) care options

These methods of managing labor pain do not include medicine. They provide varying levels of pain relief.

Methods

  • Focused breathing
  • Change positions
  • Massage
  • Bath or shower
  • Meditation or hypnosis
  • Music
  • Hot/cold therapy

Effect on baby

None

Benefits

  • Can help move labor along
  • Avoid the side effects of medicines

How long does it take/last?

  • You can use these methods throughout labor and delivery
  • Some methods need advanced preparation

Will the procedure hurt?

No

Effect on pain

Varies – may not provide as much pain relief as other options

Possible side effects or risk for mother

None


Nitrous oxide

Called “laughing gas” and often used by dentists, nitrous oxide is an inhalable gas. Nitrous oxide can take your focus away from pain, but does not eliminate all pain.

Method

Inhale during contractions through a mask you hold

Effect on baby

No evidence of impact on baby

Benefits

  • You control usage
  • Effect occurs only while inhaling gas and disappears soon after removing mask
  • Does not limit your movement

How long does it take/last?

Begins to work in 30 to 60 seconds

Will the procedure hurt?

No

Effect on pain

Varies – can take your focus off pain but does not eliminate all pain

Possible side effects or risk for mother

  • Possible dizziness, drowsiness, nausea or vomiting
  • You may be sensitive to the smell of plastic

Opioids or analgesics such as fentanyl

Opioids and analgesics are medicines that reduce pain and help you rest between contractions. This may not be a good option if you have drug addiction challenges.

Method

  • A shot given by your nurse (usually in the hip) or put into an IV (needle in a vein)
  • Usually no more than three doses given

Effect on baby

  • Reaches the baby through the placenta
  • If given close to the time of delivery, baby may be less alert. Baby may also have less interest in breastfeeding shortly after birth

Benefits

  • Can be a good option for early labor, before receiving an epidural
  • Good option for those who aren’t interested in regional pain management

How long does it take/last?

  • The shot must be ordered
  • Effects begin in 10 to 15 minutes and usually last 1 to 1.5 hours (or less, if given by IV)

Will the procedure hurt?

May feel slight sting when shot is given or when IV is inserted (if IV is used)

Effect on pain

Dulls your pain and can help you rest between contractions

Possible side effects or risk for mother

  • Nausea, vomiting, dizziness
  • Feeling itchy
  • Feeling tired or sleepy
  • You may feel less in control

Intrathecal narcotic (ITN)

Medicine is delivered through a shot to the lower back. Pain relief can vary. It isn’t recommended for first time mothers.

Method

  • Low back area is cleaned with antiseptic and a shot is given to numb the skin
  • A needle is inserted into the numbed area and a small amount of narcotic anesthesia is injected into your spinal fluid

Effect on baby

  • Generally safe for babies
  • Baby’s heart rate may slow temporarily

Benefits

  • Good pain relief
  • Effective quickly
  • Does not impact your pushing efforts (the medicine usually wears off before pushing begins)

How long does it take/last?

  • Procedure takes about 10 to 15 minutes
  • Pain relief begins 5 minutes after you receive the shot and is most effective for 2 to 4 hours
  • You may be able to receive a second shot, but this shot may not be as effective as the first

Will the procedure hurt?

May feel slight sting when you get a shot

Effect on pain

  • Usually good pain relief, but can vary
  • You may not be pain-free
  • Pain relief may wear off while still in labor

Possible side effects or risk for mother

  • Not recommended for first time mothers due to longer labor times
  • Itching
  • Nausea
  • Limited ability to walk
  • May not be able to urinate and need a catheter
  • Tenderness at injection site
  • You may need further medical interventions
  • Rare side effects include: dizziness, seizure

Epidural

Medicine blocks pain in the lower part of your body. This is usually the most effective method of pain relief. You may not be able to have an epidural if you are very overweight, have back problems or certain medical conditions like low platelets.

Method

  • You will be given fluids through an IV (needle in a vein)
  • Low back area is cleaned with antiseptic and a shot is given to numb the skin
  • A needle is inserted into the numbed area and a small amount of narcotic anesthesia is injected into your spinal fluid

Effect on baby

  • Considered safe for babies
  • Baby may have less interest in breastfeeding shortly after birth

Benefits

  • Long-term pain relief
  • Helps with relaxation
  • You’ll remain alert throughout
  • You can control the amount of medicine
  • Can help labor progress

How long does it take/last?

  • Procedure takes about 10 to 15 minutes
  • Pain relief begins 10 to 20 minutes after you receive the shot
  • Pain relief can be adjusted any time and may last through labor and delivery

Will the procedure hurt?

  • May feel slight sting when you get a shot
  • You may feel pressure in your back after it is numbed

Effect on pain

  • Labor epidurals provide pain relief in the lower abdomen, legs and birth canal
  • You may still be aware of contractions and feel pressure as the baby’s head descends, but it will be easier to manage
  • You may need to reposition to get a greater effect

Possible side effects or risk for mother

  • Ineffective pain relief
  • Limited movement
  • Decrease in blood pressure
  • May not be able to urinate and need a catheter
  • Can slow labor
  • Decreased ability to push
  • May need further medical interventions
  • Tenderness at epidural site
  • Rare side effects include: headache, fever, infection, dizziness, seizure, feels hard to breathe

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