Introduction
Many types of medication can ease pain during labor and delivery. Epidural and spinal blocks are common choices, but you have other options, too. Work with your health care team to make the best decision for you and your baby.
Click on the tabs to the left to learn more about specific medications used during labor and delivery.
Epidural block
Description
An epidural block is an anesthetic that can be mixed with a narcotic. An epidural may be used during active labor or shortly before a C-section. The medication is injected into the lower back just outside the tough sac (dura) that surrounds the spinal cord. It takes effect in about 10 to 20 minutes.
Pros
An epidural blocks most pain in the lower body without significantly slowing labor. It can be used continuously throughout labor. You'll remain awake and alert. Walking epidurals — which leave you enough muscle strength to walk during labor — are available in some facilities.
Cons
An epidural may affect one side of the body more than the other. An epidural may decrease your blood pressure, which can slow the baby's heart rate. Pushing may be more difficult or take longer. An allergic reaction is possible. Rarely, you may have the sensation of difficulty breathing or a severe headache.
Spinal block
Description
A spinal block is a mixture of an anesthetic and a narcotic. A spinal block may be used during active labor if delivery is expected within two hours or shortly before a C-section. The medication is injected directly into the tough sac (dura) that surrounds the spinal cord. It takes effect in seconds.
Pros
A spinal block provides complete pain relief from the chest down for up to two hours. You'll remain awake and alert.
Cons
A spinal block may decrease your blood pressure, which can slow the baby's heart rate. You won't be able to walk during labor. A severe headache and loss of bladder control — usually requiring a catheter — are possible. Rarely, a spinal block causes lightheadedness and nausea.
Analgesics and narcotics
Description
Various analgesics and narcotics may be injected into a muscle in the thigh or buttock or given through an intravenous (IV) catheter. If you have an IV, you may be able to control your dosage. The medication takes effect in minutes.
Pros
Analgesics and narcotics decrease the perception of pain for two to four hours. They promote rest without causing muscle weakness.
Cons
Analgesics and narcotics may cause sleepiness and temporarily depress breathing for you or the baby. High doses may decrease your memory of labor.
Local anesthetics
Description
A local anesthetic may be used to numb the vaginal area if you need an incision to extend the opening of the vagina (episiotomy) or a tear must be repaired after delivery. The medication is injected into tissue at the vaginal opening and takes effect in seconds.
Pros
Local anesthetics temporarily relieve pain in a specific area. Negative effects for mother or baby are rare.
Cons
Local anesthetics don't stop the pain of contractions. An allergic reaction is possible. Rarely, injecting the medication into a vein may decrease your blood pressure.
Pudendal block
Description
A pudendal block may be used shortly before delivery to block pain between the vagina and anus (perineum). The medication is injected into the vaginal wall and takes effect in seconds.
Pros
A pudendal block relieves pain in a specific area for up to an hour. Negative effects for mother or baby are rare.
Cons
A pudendal block doesn't stop the pain of contractions. The medication may affect only one side of the body, and it may slightly decrease the urge to push. An allergic reaction is possible. Rarely, injecting the medication into a vein may decrease your blood pressure.
Tranquilizers
Description
Occasionally, tranquilizers are used to relieve anxiety and promote rest in early labor. They may be given by mouth, injected into a muscle in the thigh or buttock, or given through an intravenous (IV) catheter. When injected or given intravenously, tranquilizers take effect in minutes.
Pros
Tranquilizers relieve anxiety and promote relaxation for several hours or more.
Cons
Tranquilizers don't relieve pain. They may cause drowsiness, decrease your memory of labor, and decrease your baby's muscle tone and activity at birth.
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