Many times the labour process can be very long, arduous, and complicated. Mothers may experience long and unbearably painful labour or the mother might be too panicky. In these cases, it is best not to jeopardize the baby and the mother, and it might make sense for medical pain relief. After all, the main objective in delivery is to take the baby out of the mother as safely and smoothly as possible.
While you're in labour, your doctor or nurse will ask if you need pain relief. Ask your hospital beforehand about the medical pain relief options they offer. The pain relief medicines administered to you will depend on your doctor, your hospital, your health history, allergies, pregnancy complications etc.
Below we offer short summaries of the various medical options available to mothers to relieve the pain of labour.
These are the most common form of pain relief used during childbirth. Epidurals block the pain of contractions by numbing the nerves that connect the uterus to the brain. This will make you feel like your lower body is numb.
Epidurals offer complete pain relief while allowing you to fully experience your labour without worrying about the pain.
In an epidural, the doctor injects the medicine into the lower part of your back. Usually the doctor will insert a tiny tube into your back and it will be left there till after your delivery. This makes it easy to administer additional dosages when you need them. The process of inserting the tube is done with extreme care as it is near your spine and you may be required to sit as still as possible when this is done.
The doctor will also start foetal monitoring of your baby to ensure that the labour is progressing well without any effect on the infant.
Some argue that epidurals may prolong labour but a study done in India, covering over 2000 pregnant women showed no significant increase in labour duration or any significant side effects or any increase in c-sections due to the epidural1.
Some side effects of epidurals are:
- It may make you shiver and may cause nausea and vomiting
- It may lower your blood pressure
- Your legs may feel heavy after getting an epidural. This may confine you to the bed and may restrict bathroom visits for bladder relief
- Some women report backaches persisting for some time after the delivery.
- You may also have a mild headache
Epidurals are regarded as safe and effective method of pain relief. They are used commonly in India and most hospitals offer these.
In a spinal block a doctor injects an anaesthetic medicine into the lower back.. Similar to an epidural, a spinal block also makes your lower body feel numb, but from the chest down. Spinal anaesthesia gives immediate pain relief. So they are often used for women who need an emergency caesarean section.
Some disadvantages of spinal anaesthesia include:
- You may you feel short of breath.
- It may lower your blood pressure.
- You may also feel some nausea and dizziness.
- A severe headache is highly probable.
A pudendal block is used late in labour when the crowning starts (your baby’s head is visible) and you need to start to push. A pudendal block is also used during an episiotomy to numb your perineum or in an assisted birth where the doctor has to use an instrument like a forceps to help your baby come out. It helps relieve pain in your vaginal area.
A local anaesthetic is injected near the vagina where the pudendal nerve is located. It provides pain relief quickly in that area.
Pudendal block has very few risks other than a slight chance of a drop in blood pressure.
These are mild medicines that are given earlier during labour. While they do not get rid of the pain (like an epidural) they help you to “take the edge” off and make the pain more bearable. These pain medications are usually injected into a muscle or into your bloodstream.
Typically, after taking this medicine, most women ask for an epidural later to get rid of the pain totally.
Here are some possible side effects of these medications:
- They may make you feel sleepy.
- They may make you dizzy and nauseous and trigger vomiting.
- They can affect your memory and may result in vague memories of your labour experience.
- These medicines cross into the baby’ blood and may make the baby drowsy as well.
1. Pankaj Desai, Puri Patel, Ashoo Gupta, Gurpreet Kaur Virk, Archana Singh “Epidural analgesia in labor”, J Obstet Gynecol India Vol 56 No 5 September/October 2006, Pg 417-422