Managing pain during labor

The pain felt during childbirth is different for every woman. Some women choose natural childbirth, or giving birth without medicine for pain. If all goes well, it can be a great experience.

If you want to deliver without medicine, take a childbirth class. Childbirth classes teach breathing and relaxation techniques. These techniques can help you relieve pain naturally during birth. And, they can add to the relief you get from medicine if you choose to take it.

For some women, the techniques learned in childbirth classes are enough to relieve their pain. Other women may choose to use pain medicine during childbirth.

Having a doula present during labor may also help greatly to tolerate natural child birth.

A systemic analgesic is a pain medicine that is injected into your vein or muscle. This medicine acts on your entire nervous system rather than just a certain part of your body. The pain may not completely go away, but it will be dulled.

With systemic analgesics, some women have an easier labor and feel more relaxed. These medicines often do not slow down labor. They also do not affect contractions.

But, they make you and your baby drowsy. Some women complain of feeling like they lose control.

An epidural block numbs or causes a loss of feeling in the lower half of your body. Your health care provider who specializes in anesthesia injects the block into your lower back. This lessens the pain of contractions and makes it easier to deliver your baby through your vagina.

Epidural is the safest and most effective pain-relieving procedure. Most women choose an epidural to manage the pain of their labor. Facts about epidurals:

• There is no sedating effect on you or your baby.
• The risks are small.
• The chances of needing a cesarean delivery (C-section) do not increase.
• Labor sometimes is slightly longer if you receive an epidural.
• Many times an epidural can allow labor that has stalled to progress.
• Epidurals can be repeated throughout the duration of labor.
• The biggest side effect of an epidural is numbness and lack of movement (mobility).

Local anesthesia (pudendal block) is a numbing medicine that your provider injects into your vagina and rectal areas when you are close to delivery. It lessens the pain as the baby passes through the numbed area.

Keep in mind that a plan is just a plan. Be flexible when you are planning for your labor and delivery. Things often change when the actual day arrives. Many women decide before going into labor to have natural childbirth. Later, they change their mind and decide they want pain medicine after all. It is OK to change your mind.

Other women plan on pain medicine, but they arrive at the hospital too late. Sometimes, the baby is born before the woman can get pain medicine. It is a good idea to go to childbirth classes and learn about breathing and relaxation techniques, even if you plan to get pain medicine.

Talk to provider about the different types of pain relief for your labor and delivery. The health and safety of you and your baby come first, so your provider may recommend one type of pain relief for you over others. It is good to know all of your options so you can make the best plan for your labor and delivery.

Pregnancy - pain during labor; Birth - managing pain

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Sharpe EE, Arendt KW. Anesthesia for obstetrics. In: Gropper MA, ed. Miller's Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 62.

Thorp JM, Grantz KL. Clinical aspects of normal and abnormal labor. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 40.

Updated by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.