Pain management

Preferences for comfort management during labor and delivery are different for each woman. You are invited to consider and explore the pain management options, and select the option that best meets your needs. Your care team wants to partner with you to provide the support and assistance you desire. You can help by informing the team of the plans you made with your provider to manage your comfort during labor.

Labor and delivery comfort measures without medication
Comfort measures and labor support are encouraged and promoted, as they can be the most effective comfort resources you have during childbirth. Your labor partner or coach, and the nurses, will help you initiate the comfort measures you prefer. Comfort measures also can enhance the positive effects of any anesthetic or medications you choose.

You can enjoy relaxing, walking, listening to music, breathing in a pattern, showering or using a whirlpool tub to manage labor pain and fear you may feel during labor. You will be encouraged to change position to help with cervical dilation and help you deal with the intensity of labor. Often, walking, sitting or rocking in a rocking chair or on a labor ball can be good choices for position changes as long as it is safe for you and your baby.

Labor and delivery comfort measures with medication
These medicated options are available for comfort:

• Continuous labor epidural. This epidural involves placing a needle into the lower back. A small catheter is passed through the needle into the epidural space. The needle is then removed, and the catheter is taped into place. The catheter allows a continuous infusion of medicine, which is a combination of local anesthetic and a narcotic. Most women who receive this type of epidural are fully able participate in the birth experience, and maintain the ability to feel touch and pressure while relieving most, if not all, of the pain of labor.

• Intrathecal narcotic. This is a one-time injection given in the lower back. It is a combination of local anesthetic and a narcotic that causes rapid loss of feeling below the waist. It usually lasts two to four hours, and generally is used for women who have achieved a high degree of cervical dilation and are expected to deliver soon.

• IV narcotic. A narcotic is administered through an IV into a vein throughout labor. It can be used any time during labor as long as delivery isn't anticipated to occur soon after the medication is given. While this will not take all of the pain of contractions away, IV narcotics can make contractions more tolerable.

• Nitrous oxide (laughing gas). This is an odorless, tasteless gas that is inhaled through a hand-held face mask during labor. Once inhaled, it only takes a few minutes to notice the effect. The gas dulls the pain and reduces anxiety, but it does not eliminate the pain. You control the amount of the laughing gas you use. It can be used only as needed or continuously during labor. You still are able to walk during labor. You may become drowsy, but you can simply stop inhaling for the effects to wear off.