Frequently Asked Questions
The excitement of your child's birth often makes you wonder what labor will be like. Each woman's labor is unique, and each woman experiences labor discomfort differently.
Some women achieve adequate pain control during labor and delivery with the breathing and relaxation techniques they learn at childbirth classes. Other women find these techniques most effective when combined with other pain relief methods.
It is important for you to learn what pain relief options are available during childbirth. Decisions regarding control of your labor pain must be made specifically for you. Remember, however, that your pain relief choices may be governed by certain circumstances of your labor and delivery. Throughout your labor, your health care provider will assess your progress and comfort to help you choose a pain relief technique.
Your health care provider may ask an anesthesiologist (a physician who specializes in pain relief) to talk with you about pain relief during labor. The anesthesiologist will be happy to answer your questions.
Analgesic medications can be injected into a vein or a muscle to dull labor discomfort. Because analgesic medications affect your entire body and may make both you and your baby sleepy, they are mainly used during early labor to help you rest and conserve your energy.
Local anesthesia may be used by your health care provider during delivery to numb a painful area or after delivery when stitches are necessary. Local anesthetic medications do not reduce discomfort during labor.
Regional anesthesia (also called epidural or spinal anesthesia) is administered by an anesthesiologist during labor to reduce discomfort. In both epidural and spinal anesthesia, medications are placed near the nerves in your lower back to block pain in a wide region of your body while you stay awake. Regional anesthesia greatly reduces or eliminates pain throughout the birthing process. It can also be used if a cesarean birth becomes necessary.
General anesthesia is used for emergencies during the birthing process. General anesthesia induces sleep and must be given by an anesthesiologist. While safe, general anesthesia prevents you from seeing your child immediately after birth.
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Your anesthesiologist will inject medications near the nerves in your lower back to block the discomfort of contractions. The medication will be injected while you are either sitting up or lying on your side.
After reviewing your medical history and asking you some questions, your anesthesiologist will numb an area on your lower back with a local anesthetic. A special needle is inserted into this numb area to find the exact location to inject the anesthetic medication. After injecting the medication, your anesthesiologist removes the needle. In most cases, a tiny plastic tube called an epidural catheter stays in place after the needle is removed to deliver medications as needed throughout labor.
The best time to administer regional anesthesia varies depending on you and your baby's response to labor. If you request regional anesthesia, your health care provider will contact your anesthesiologist and together they will discuss with you the risks, benefits and timing of regional anesthesia.
If you request regional anesthesia, you may receive epidural or spinal anesthesia, or a combination of the two. Your health care provider will select the type of regional anesthesia based on your general health and the progress of your labor.
Considerable research has shown that regional anesthesia is safe for you and your baby. While your baby receives a small amount of any medication that you receive, regional anesthesia techniques minimize the amount of medication you and your baby receive.
Epidural anesthesia starts working 10 to 20 minutes after the medication has been injected. Pain relief from epidural anesthesia lasts as long as your labor, since more medication can always be given through the catheter.
Spinal anesthesia starts working immediately after the medication has been injected. Pain relief lasts about two and one-half hours. If your labor is expected to last beyond this time, an epidural catheter will be inserted to deliver medications to continue your pain relief as long as needed.
Although you will feel significant pain relief, you may still be aware of mild pressure from your contractions. You may also feel pressure when your health care provider examines you.
Not necessarily. Your anesthesiologist can tailor the anesthesia to allow you to sit in a lounge chair or walk. Walking or sitting may even help your progress in labor. If you are interested, ask your anesthesiologist about a walking epidural.
In some women, contractions may slow after regional anesthesia for a short period of time. Most women find that regional anesthesia helps them to relax and actually improves their contraction pattern while allowing them to rest.
Yes. Regional anesthesia allows you to rest comfortably while your cervix dilates. When your cervix is completely dilated and it is time to push, you will have energy in reserve. Regional anesthesia should not affect your ability to push; it will make pushing more comfortable for you.
Your anesthesiologist takes special precautions to prevent complications. Although side-effects are rare, they occasionally include:
Decreased blood pressure. You will receive intravenous fluids and your blood pressure will be carefully monitored and treated to prevent this from happening.
Mild itching during labor. If itching becomes bothersome, your anesthesiologist can treat it with medication. Most women find the itching to be quite mild.
Headache. Drinking fluids and taking pain tablets can help relieve headaches after regional anesthesia. If the headache persists, tell your anesthesiologist and additional medication can be ordered for you.
Local anesthetic reaction. While local anesthetic reactions are rare, they can be serious. Be sure to tell your anesthesiologist if you become dizzy or develop ringing in your ears so that he or she can quickly treat the problem.
Persistent pain in some areas. Sometimes the anesthetic does not reach an area leaving a "spot" which is still painful. Your anesthesiologist may change your position or move the epidural catheter to relieve the pain. Occasionally, the regional anesthetic may need to be repeated to get relief. In either situation, your anesthesiologist will work with you to make you comfortable.
If you have any health conditions that you feel might influence your labor or pain relief during labor, please tell your health care provider. A consultation can be arranged with the anesthesiologist at a convenient time during your pregnancy.
The Society For Obstetric Anesthesia &
Perinatology
1910 Byrd Avenue, Suite 100
P.O. Box 11086
Richmond, VA 23230-0090
(804) 282-5051