Pain Management Options for Labor

Bringing a child into the world is an experience like no other. And for most people, they experience pain at some point during childbirth — though the amount of pain varies greatly from person to person.

Some people wish to avoid pain medicine and use relaxation or other techniques to manage pain during labor. Others choose to use some form of pain medicine. At Overlake Medical Center & Clinics, our team is here for you throughout your birth experience. We’ll help you understand your pain management options and make informed choices at every step of labor.  

Do I need to decide if I want pain relief before I’m in labor?

Some people decide if they want pain relief ahead of time, while others take a “wait and see” approach. While you don't need a concrete plan ahead of time, it's best to educate yourself about your pain management options before birth. This will help you make an informed decision when the time comes, rather than having to decide under the stress of labor. Resources to help you understand your pain management options during childbirth include:

• Your midwife, obstetrician or family practice provider.
• Overlake’s childbirth classes.

Pain Relief During Labor and Vaginal Birth

Pain Management Without Medicine

Your care team will teach you about various options to help cope with pain without medication, including:

• Changing your position.
• Breathing techniques.
• Using heat or cold.
• Using light, smells or sounds.
• Trying massage, stroking or cuddling with your labor partner

Your birth suite will also be equipped with birth balls and peanut balls, in different sizes to fit all bodies, and private soaking tubs to help you cope with pain during labor.

Pain Management With Medicine

Nitrous Oxide

Nitrous oxide (sometimes called laughing gas) can help you manage pain and anxiety during labor and delivery. Odorless and tasteless, nitrous oxide is a gas delivered through a small face mask. It’s a good option if you are prone to anxiety because you control it — you can put on or take off the mask as needed. Nitrous oxide relaxes the central nervous system to dull the perception of pain, but does not completely block it. It can also create a sense of well-being.

Some people choose to try nitrous oxide first, and then, if needed, move to a stronger option such as an epidural. Nitrous oxide starts working within a minute and leaves the system quickly when you stop using it. It does not limit mobility, so you can walk or move around during labor. Nitrous oxide does not slow labor or cause significant risk to the baby – and you can safely breastfeed right after your baby is born.

Intravenous (IV) Pain Medication

IV medications are another option to help manage pain during labor. They’re given through a vein and often provide enough pain relief to tolerate labor. These medications can make you and your baby somewhat sleepy. 

Epidurals (Regional Blocks) 

Epidurals are common pain management options during labor. They block pain in a specific part of your body. At Overlake, epidural anesthesia is the most common method used to control labor pain. If you choose to have an epidural, here’s what to expect:

• An anesthesiologist will be with you and closely monitor you throughout the process of placement.
• Before the epidural, you may need lab work or extra fluid.
• A small needle and numbing medication is used prior to placement
• To help make sure the medication gets into the correct place (the space around your spinal nerves and not your blood vessels), your anesthesiologist will start with a small test dose.
• To do this, they'll insert a needle into your lower back while you are seated or lying down. Some people feel a mild burning sensation during this process, but it only lasts a few seconds. Some people feel a strange sensation in the pit of their stomach.
• Within 10-20 minutes, most people feel a warming sensation beginning in their legs and spreading into their belly. Numbness starts soon after the warmth, and how numb you become depends on the type and amount of medication.
• You usually will also lose some strength in your legs. This means you will not be able to get out of bed and walk. But most people still have enough strength to push when they need to and the care team will help you know when.
• You’ll continue to receive small amounts of medication throughout your labor. Most people will still feel a pressure sensation in their birth canal, which is helpful when it's time to push. 

Are epidurals safe for me and my baby?

Epidural anesthesia has a long record of safety for childbirth. Your baby is not likely to experience any side effects of the medication. And we'll monitor them during the entire labor process, ready to quickly address any rare problems.

As with any type of anesthesia, it’s possible to experience rare side effects, including:

• Lower back tenderness and backaches after birth.
• A headache (commonly called a spinal headache) within 48 hours after birth.

For most people, this headache gets worse when you stand up and better when you lie down. These headaches can go away on their own. Or your anesthesiologist can give you an epidural blood patch to treat a spinal headache.

Am I a candidate for an epidural?

Most people can have an epidural. But sometimes, they’re not possible if you have:

• A bleeding disorder.
• Certain infections.
• Had previous back surgery.
• Extreme obesity.

Ask your doctor or midwife if you have questions about being able to have an epidural. 

Pain Management for Cesarean (C-section) Births

You, your care team and your anesthesiologist will decide which type of anesthesia is best for you based on why you need a C-section and how urgent it is. And they can answer any questions and provide support and the best possible care every step of the way.

For example, you may need a C-section if your baby is in the wrong position or if you are having twins or triplets. Some people need a C-section because of a medical emergency. Your anesthesiologist will help you understand which option is best for you. Options include:

• Epidural anesthesia. For non-emergency C-sections, epidural anesthesia is frequently used. If you’ve already had an epidural before going into labor, it can be used during a C-section. In an emergency C-section, epidural anesthesia may take too long to be effective. So your doctor may recommend a different form of anesthesia.
• Spinal anesthesia. Spinal anesthesia blocks pain in the lower half of the body. This type of epidural is used for both non-emergency and emergency C-sections. It is often the method of choice during an emergency because it starts working very quickly.
• General anesthesia. This type of anesthesia puts you in a sleep-like state where you do not feel any sensations or pain. General anesthesia is only used in emergency C-sections or when other types of anesthesia are not possible.

Your labor support person and doula are typically allowed in the operating room, but if general anesthesia is needed for an emergency C-section, your support people will be asked to wait in the waiting room.

If you have any questions about managing pain during labor and birth, talk to your pregnancy provider or call our anesthesia hotline at (425) 646-5825.