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Labor & Delivery

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No Pain, No Gain

We often hear that giving birth entails a lot of sacrifice from mothers, mostly because of all the pain they have to endure during labor and delivery.

While some mothers have managed very well without any kind of pain relief, not everyone has the same level of threshold for pain. Because of this, opting for medication for pain during the delivery is one of the things you should determine before you go into the delivery room or an option that you should note in your birth plan.

Below are some of the most common pain alleviation options for reference:

1. Natural Pain Relief
If you opt to go about labor the natural way, there are still some measures you can take to lessen your labor pains. Below are the most common methods you may want to consider:

• Warmth
A sure way of soothing aching and tense muscles to ease the pain is to apply warmth to the area. Some ways to achieve relief through warmth are using a hot water bag, getting a massage (skin to skin heat transfer), or even through the use of a birth pool. Note however that you should only be in a birth pool when you’re sure that you’re in labor and your cervix is around 5cm dilated. The relief that warmth can give you can extend to mental relaxation so you can be ready for the next stage.

• Breathing
Doing breathing exercises can help immensely with the pain during contractions. Breathe in through your nose and out through your mouth with your mouth slightly open. The rhythmic breathing can not only help in easing the discomfort but also conserve your energy for the delivery.

2. Epidural
Epidural is the most popular type of pain alleviation method. It is a regional anesthetic that is to be administered only by an anesthetist. This kind of assistance doesn’t affect your entire body and it should leave you with sensations in your legs and feet during delivery that is why normally, an epidural will allow you to be alert to still be able to actively participate in your birth.

The World Health Organization recommends “epidural for healthy pregnant women requesting pain relief during labour, depending on a woman’s preferences.” However, like any other kind of pain relief, going down the epidural route also has its advantages and disadvantage such as a possible drop in blood pressure, headache, backache, soreness, numbness in lower part of the body. There are also studies that suggest that it can cause breastfeeding difficulties as newborns experience trouble latching on. To avoid complications and preserve as much motor function as possible, the lowest possible effective concentration of local anaesthetic should be used when administering epidural analgesia

3. Spinal Block
This type of medication is typically used to block pain during a C-section. However, a single shot spinal block can be used as a regional analgesic if delivery is expected in a short time or if forceps or vacuum extraction is needed and there is enough time for the procedure. During a spinal block, the medication is injected into the fluid below the spinal cord in the lower back and takes effect right away. A spinal block is sometimes combined with an epidural block during labor (combined spinal-epidural block). It is given only once and in a small dose and provides complete pain relief in the lower body for a couple of hours which enables you to remain awake and alert. However, it might decrease blood pressure which can slow the baby’s heart rate.

4. Opioids
Different kinds of opioids can be used to lessen pain during labor. They can be injected into a muscle or given through an intravenous (IV) catheter without the need for an anesthesiologist. On the other hand, opiods are not meant to totally get rid of labor pain and won’t work to eliminate delivery pains. Like the epidural, this might also interfere with baby’s initial breastfeeding as it may affect newborn’s breathing and cause drowsiness.

5. Local anesthetic injection
A local anesthetic might be used to quickly numb the vaginal area if you need an incision to extend the opening of the vagina (episiotomy) or repair a tear after delivery. The medication is injected into the area around the nerves that carry feeling to the vagina, vulva and perineum. Local anesthetics temporarily numb a specific area. Negative effects for mother and baby are rare. Some of the disadvantages of this type of pain relief are: possible allergic reaction, toxic reaction that could affect the central nervous system and even the heart.

6. Nitrous Oxide
An odorless, tasteless gas, this type of pain alleviation method is done through inhalation of analgesic with a mask during labor. It takes effect within a minute. One of the disadvantages of Nitrous oxide is that you can control the amount that you use and you’ll be able to walk during labor. Plus, it has no effect on the baby. Nitrous oxide doesn’t eliminate pain. To experience relief, you’ll need to time inhalation of nitrous oxide so that it occurs about 30 seconds before you expect each contraction. You might experience nausea, vomiting, dizziness and drowsiness.

Source:
Baby Centre. Natural pain relief in labour. Retrieved 9 October 2018 from: https://www.babycentre.co.uk/a546717/natural-pain-relief-in-labour
Mayo Clinic. (08 July 2017) Labor and Delivery: Pain Medications. Retrieved 8 October 2018 from: https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/labor-and-delivery/art-20049326
American Pregnancy Association. (24 March 2017). Using Epidural Anesthesia During Labor: Benefits And Risks. Retrieved 8 October 2018 from: http://americanpregnancy.org/labor-and-birth/epidural/
World Health Organization. (17 February 2018). WHO recommendation on epidural analgesia for pain relief during labour. Retrieved 8 October 2018 from: https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/care-during-childbirth/care-during-labour-1st-stage/who-recommendation-epidural-analgesia-pain-relief-during-labour

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