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Feature Article Know Your Options for Coping with Labor Pain

By Emily Yeast, certified nurse midwife, Samaritan Obstetrics & Gynecology – Corvallis

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Childbirth labor is different for every woman, making it hard to feel prepared. It’s good to know your options, as well as learn about ways to ease the discomfort you may feel.

Non-medicinal approaches include:

  • Staying physically active during pregnancy. Women who are in good physical shape have more strength to get through labor.
  • Having a support person such as your partner, a friend or a doula provide encouragement and comfort
  • Massage or counter-pressure on your back or hips during contractions
  • Changing positions, walking, sitting on a birth ball or dancing
  • Music, aromatherapy
  • Warm bath or shower
  • Making a noise, singing or humming during contractions or between for relaxation

In addition, there are several medication options:

IV pain medication: There are several different narcotic medications, which will block the pain signal from getting to your brain. These medications will not take away the pain entirely, but will make you feel more relaxed and not as concerned about the pain you may be sensing. IV pain medications may make you feel too tired to get up and move around. These medications are not given close to delivery because they can make your baby too sleepy when it is taking its first breaths.

Medicine to help you sleep: If you are in early labor and are very tired, sometimes it can be a good idea to take some medicine to help you sleep so you will have energy to manage active labor when it comes. A medication such as Benadryl®, Vistaril® or Ambien® may be recommended. If your contractions are painful and keeping you awake, your provider may also recommend a pain medication like morphine.

Nitrous oxide: This is a gas mixture of half nitrous oxide and half oxygen hooked up to a mask. It works in about 30 seconds and the effects go away a minute or two after you stop breathing the gas. You hold the mask yourself, so you control how much you use. Nitrous oxide helps you relax so you don’t care as much about the pain, which can help relieve anxiety. You can still get up and move around while using nitrous oxide as long as you are steady enough on your feet. Nitrous oxide does not have any effect on labor progress, and there are no known side effects to your baby.

Epidural: An epidural can take away most or almost all of your labor pain. An epidural is placed by an anesthesiologist, using a needle and catheter, into a space between the bones of your spine. A small amount of anesthetic (numbing) medication is injected into the area next to your spinal cord where the nerves from your uterus and legs come into your spine; this medication blocks the pain signal to your brain. The catheter continuously delivers medication and is not turned off until after your baby is born.

An epidural can make it take longer to push your baby out and increases the chances that you will need forceps or a vacuum to deliver your baby. Woman who have an epidural are more likely to need Pitocin, a medication that helps the uterus contract, and other labor interventions. Occasionally a woman’s blood pressure drops after the epidural is placed, and this can cause the baby’s heart rate to drop, too. This is temporary and can be fixed by giving medication to the mom to bring her blood pressure up, but can be scary when it happens.

Some hospitals may not offer all of these options for pain management, so be sure to talk to your prenatal care provider during pregnancy to find out what is available. Being prepared – by talking to your provider, attending childbirth preparation classes, reading books and watching videos – can make labor less scary and easier to handle.

Learn more about Samaritan’s options for pregnancy, labor and delivery at samhealth.org/Mommy.