One of the biggest concerns any pregnant woman has is how she will deal with the pain of childbirth, even if this will not be her first experience of labour. There are a number of options that are usually available to pregnant women to help ease the pain and each of them is rather different. Understanding what your options might be ahead of time will mean you can make a better decision when the time comes when clear headedness and rational thinking will become a lot harder than usual!
Entonox – Also known as air and gas entonox is a combination of half oxygen and half nitrous oxide (aka laughing gas) that can be inhaled to provide a measure of pain relief. Essentially it “takes the edge off” the pain without numbing you completely.
In most hospitals and birthing centres the Mum to be has complete control over the entonox and is given a mask to inhale as as when she feels she needs it after she has been shown how to use it properly. Many Mums find this to be a huge advantage because it means they can keep a handle on the pain without waiting for the nurses to reenter the room.
Entonox also has the advantage that it does not remain in Mum’s system and has no major side effects. On the other hand though it is only a mild painkilller and some women find it is not enough to help them deal with the pain, especially in the later stages of labour. Some also dislike the light headed, slightly nauseous feeling that it can produce.
Systemic Medications – Systemic medications like narcotics offer pain relief that is stronger than entonox. Narcotics are sometimes also administered together with a tranquilizer to reduce anxieties and stress that many Mums to be in labour find very hard to deal with.
Usually these medications are either administered by IV gradually or by direct injection and they act on the whole body rather than just the pelvic region. They do often make Mums feel rather sleepy and not too alert but they will not produce unconsciousness.
Epidurals – An epidural delivers constant pain relief to lower body, providing relief without making Mum too drowsy, allowing her to remain far more alert during the birthing process, something that many women feel is very important.
The epidural medication is usually a combination of a narcotic pain reliever and a local anesthetic. The local anesthetic block the sensations of touch, movement and even temperature. The narcotic provides pain relief without reducing sensation in your legs and the combination of the two drugs means you can receive them at lower doses than if used separately.
The epidural medication is delivered via a hollow needle that is inserted into the space just outside the membrane that surrounds your spine. Once inserted into this epidural space the needle is designed to remain in place until after Baby is born, providing pain relief constantly.
Spinal Block – A spinal block differs from an epidural in that it is delivered directly into the sine as a one time injection. The effects are therefore immediate and will remain for a few hours. A spinal block is most often used if a Mum to be decides she wants pain relief in the late stages and their will be no time for an epidural to have any noticeable affect.
Combined Epidural and Spinal Block – This is a newer pain relief technique for women in labor that is designed to provide just the right levels of pain relief in all stages of labor. In the early going medication is delivered via a spinal block which causes less leg weakness than an epidural so Mum should still be able to move fairly freely and get up and walk a little if she wants to. In the later stages an epidural provides the extra level of continuous relief that can be very helpful!
There are pros and cons attached to all of these pain relief techniques and they should be discussed with your OB or midwife well in advance so that you are informed about all of the options that will be available to you.
In the end the decision which pain medications should be used during labor is a decision for Mum and her medical staff only. You will always find those people who advocate for “natural childbirth” and alternative pain relief techniques and for some women these can work, but you should never feel pressured into passing up help that is available, something that could ease your pain, just because someone else has a negative opinion about the use of pain relieving medications and techniques during labor.