All about Pregnancy

       Pain relief in labor & birth  
 



Reliable information on
pregnancy topics
by Heisje de Jong,
Certified Lactation Consultant

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Pain relief in labor & birth
Medical intervention during
    labor and delivery

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Why do we experience pain in labor and birth? Let us have a look at some sources of pain.

FEAR AND ANXIETY

Fear and anxiety can actually cause pain. Not knowing what to expect aggravates the fear. Therefore, try to get as much information as possible. Talk with your doctor about your fear and questions. Take childbirth classes. These classes usually provide you with lots of information and you will meet other mothers to be to share your concerns with. This will put you more at ease and will make you feel more relaxed and comfortable.

 

CERVICAL DILATATION

Holding your breath and fighting the pain can hinder dilatation and can make labor more painful. Lying immobilized on your back can also aggravate the pain. Changing positions and remaining mobile during labor can reduce pain. Breathing exercises and relaxation techniques can help you cope with the pain.

CONTRACTIONS

Contractions are tightenings of the uterus. The peak of the contraction, when the uterus is working hardest and most effectively, is most likely to be painful. Using your breathing and relaxation techniques will be of help. Try not to remain in one position. A firm back massage will also help to relieve the pain.

DO YOU NEED PAIN-RELIEVING DRUGS DURING LABOR?

You should make your own informed decision as to whether you want drugs during your labor. No one should force pain relief on you. If you have been to childbirth classes, the fear and tension that can help promote pain in labor should be diminished. However, you may find that despite using breathing and relaxation techniques you still feel the need for pain relief.

There is a variety of pain-relieving drugs available and different drugs suit different women. Pain relieving drugs pass however through your bloodstream to your baby. Some affect the baby more than they affect others. Certain drugs can cause breathing difficulties in your baby or make him limp and drowsy at birth. This can also influence the early mother-baby bonding and breastfeeding. You may want to try natural forms of pain relief such as massage, a hot bath or shower or acupuncture before accepting chemical pain relief. If you decide during labor that you need to use drugs, do not feel you have failed. No woman is the same and no birth is the same. You should go through labor to see what you can achieve, not what you can endure.

ANALGESICS

Commonly used drugs for pain relief in labor are Demerol (also called Pethedine) and Nalbuphine (also called Nubain). These drugs are usually given by intramuscular injection. They are effective pain relievers. Fairly common side effects of these drugs are drowsiness, dizziness, and nausea. They may also make your baby sleepy at birth making it more difficult to breastfeed after birth and to bond with him. They can also cause breathing difficulties in your baby.

EPIDURAL ANAESTHESIA

The most popular form of pain relief nowadays is a regional anaesthetic known as an epidural. The anaesthesia is injected into the space between the spinal cord and the dura, the outer membrane around the spinal cord. A fine plastic tube is left in place so top up injections can be given. When the epidural is administred you may be asked to sit up and curl forward or to lie on your left side curled up like a ball. An epidural can provide complete pain relief from the waist down and can be used for a caesarian section as well. A big advantage of epidurals over analgesics is that you don't become drowsy. You are completely awake while you do not feel the pain.

There are however some drawbacks to epidurals.
· Hypotension. An epidural can cause your blood pressure to drop. Sometimes other drugs need to be given in order to raise your blood pressure again.
· You will probably need a catheter to empty your bladder since you have no feeling in your bladder. You will also get an IV.
· Your mobility is restricted since you have to remain in bed.
· Increased likelihood of forceps, vacuum or caesarian delivery because you do not feel the contractions and do not feel how to push effectively.
· Some mothers complain of headache or backache after an epidural.
· Baby can be drowsy at birth and have a poor sucking reflex.

Accepting or rejecting pain relief during labor, the choice should be completely yours. Make sure that whatever form of pain relief is offered to you, is explained clearly. The effects, as well as the possible side effects. The anaesthesia nowadays, used only when necessary, seems to be fairly safe for the baby.