It’s well known that childbirth can be a painful experience. The pain is affected by numerous psychological and physiological factors, and women experience its intensity and severity to varying degrees. But, the fact is, most women want pain relief at some point during the process.
There are several options for pain relief during labor and delivery: some are simply strategies to help women cope with pain and do not involve medications (also called non-pharmacological methods), and other strategies rely on medications (pharmacological methods) to manage the pain. All of these options have advantages and disadvantages that you and your healthcare team can consider.
Pain relief without medication
Non-pharmacological methods of pain relief include activities like yoga, music, breathing techniques (such as Lamaze), and massage. These methods promote relaxation and can distract women from labor pain. Women who use these mind-body techniques often report less intense pain and higher satisfaction with the childbirth process. These non-pharmacological methods also have no risk of negative effects for mothers or babies. Roughly 40% of women try some form of non-pharmacological pain relief during labor.
For more ideas on how to relieve labor pain without medication, check out this post.
Medications to relieve pain
Pharmacological methods can be divided into analgesics (medications that lessen pain without loss of feeling or muscle control) and anesthetics (medications that block sensations, including pain, and muscle control).
Another way to divide pharmacological methods is by the area in which they work. Systemic medications affect the entire body: they have an overall calming and pain-relieving effect. Local medications affect only a small area: they provide pain relief only near the area in which the medication was applied or injected, such as the vagina, vulva, or perineum. Regional medications affect a larger area than local medications, but still do not affect the entire body: for example, during labor, regional analgesics or anesthetics can be used to block pain below the waist. General anesthesia makes you lose consciousness: this is not used very often during labor and delivery, except in the case of emergencies.
Opioids are systemic analgesics that can be used during labor. They are administered as a shot or through an intravenous line directly into your blood stream. They start working within a few minutes and are effective pain relievers for most women. Side effects of opioids include itching, nausea, vomiting, dizziness, and trouble concentrating. Overall, opioids are safe for mother and baby, but they usually cannot be administered too close to delivery. Opioids may slow your baby’s breathing and make the baby drowsy after delivery; this does not cause long-term problems for the baby, but it might make breastfeeding difficult at first. One study reported that about 16% of women used opioids during labor, and the most common medications included fentanyl and morphine.
One of the most common forms of pain relief for a vaginal birth is a form of regional anesthesia called an epidural. Pain-relieving medication is administered directly to the space around the spinal cord in your lower back. This method leaves you alert and able to respond to your body’s cues to push but eases the pain of uterine contractions.
Overall, 60% to 70% of women choose an epidural for pain relief. About 1% of women who use an epidural for pain relief require additional pain medications. Despite common misconceptions, epidurals do not slow down labor and they do not increase the chance of having a cesarean delivery.
Regional anesthesia may also be used for a cesarean delivery. (In the United States, C-sections happen in about 1 in every 3 births.) Many women receive an injection of medication into the spine. This type of anesthesia makes you lose feeling and control of your entire lower body. Mothers will not feel the pain of a surgical procedure, but they are able to stay awake and conscious during the birth of their child.
When considering your birth plan, always choose the method of pain relief that is right for you and your baby, and be proactive about your choice and discuss it with your healthcare team ahead of time.
Choose for yourself
Among women who chose any form of pain relief (non-pharmacological or pharmacological), 9 out of 10 said the method they chose was effective. When considering your birth plan, always choose the method of pain relief that is right for you and your baby, and, regardless of what method of pain relief you choose during labor and delivery, be proactive about your choice and discuss it with your healthcare team ahead of time.