Pain often is a part of the labor process. It occurs because of the things your body has to do during childbirth. Your cervix softens and opens up. Your uterus contracts to push the baby out. Your birth canal and vagina stretch to allow the baby to exit. We all have a certain level of pain that we can handle. We also react to pain in different ways. This means that your labor process will differ from someone else’s.
How you want to deal with childbirth pain is an important decision. You will work with your obstetrician (OB) doctor and your anesthesiologist (pain) doctor. They will talk through your options and provide recommendations. If you have a high-risk pregnancy, this will play a part. You should create this plan with them early on so you are prepared and know what to expect.
Keep in mind that a plan is what you want to happen. It is the best-case scenario. However, plans can change based on pre-labor and labor. Factors include your baby’s size and position, your physical and emotional state, and the labor process (if it’s moving fast or slow). It also depends on if you’re having a vaginal delivery or cesarean delivery (C-section). A C-section is surgery to remove your baby through an opening in your uterus and abdomen.
You can choose to deal with childbirth pain in a natural way or by using medicine. Most people do a mix of both. Talk to your doctor in depth to weigh all the factors of childbirth and managing pain.
If you choose a natural route, you will not receive any pain medicine. You still can receive medical care, but you will rely on natural methods to manage your pain instead of medicine. These include special breathing techniques and other approaches. You might want to plan for exceptions to get medicine if problems occur. It’s okay if your initial plan for a natural childbirth changes and you end up wanting pain medicine.
Lamaze: This is the widest known and practiced method. It often is taught in birthing classes that you take before delivery. It involves ways to relax your body and mind when you’re having pain. These include breathing exercises, forms of distraction, and massage. Lamaze is done with the support of a coach, who can be your partner or another person. This technique can be combined with medicine if you choose.
Bradley method: This approach focuses on a healthy, active pregnancy and mental rest in labor. This practice only believes in natural childbirth and cannot be used with medicine. There can be an exception for serious problems.
Waterbirth and HypnoBirth are a couple of other natural approaches that are becoming more popular. Some women consider water to be a relaxing setting and more natural entry for the baby. Little research exists on the safety and value of this approach. HynpoBirth focuses on a state of mind where childbirth is painless. It teaches you how to detach from the fear of labor and have a calm childbirth.
Additional natural things you can try to deal with pain include:
- Changing positions.
- Going for a walk.
- Yoga or stretching.
- Using a heating pad or cool towel.
- Taking a bath or shower.
- Listening to music.
- Meditation or visualization.
- Anything else that helps relax or distract you.
There are two main types of pain medicine you can get while you’re in labor. Analgesics help relieve pain and anesthetics help block, or prevent, pain. With either form, it is likely that you still will have some pain before, during, or after childbirth. Not everyone qualifies for medicine based on their current medical state. Talk to your doctor in advance about the benefits and risks of each type of medicine.
Regional anesthesia: This type of treatment affects a region of your body. It can be used if you’re having a vaginal birth or C-section. There are side effects and rare severe problems, but the medicine is less likely to affect your baby.
- An epidural block is the most common form of medicine used today during childbirth. In an epidural, medicine is injected into the spinal fluid in your lower back through a thin tube (catheter). It blocks the nerves that travel from your spine to the lower half of your body below the belly button. The doctor releases the desired amount of medicine through the epidural, which mostly numbs the affected area.
- A spinal block is similar to an epidural, except medicine is injected through a needle instead of a catheter. Spinal blocks are not common practice in childbirth.
- A combined spinal-epidural (CSE) block is when you get both a spinal block and an epidural.
Local anesthesia: This type of treatment numbs specific areas, such as the uterus, vagina, or abdomen. It can be used if you’re having a vaginal birth or C-section. One example is a pudendal block, which helps numb the area around your vagina and anus. This form of medicine typically does not affect your baby because it is done right before delivery.
General anesthesia: This type of treatment affects the nerves in your whole body. You won’t have any pain because it puts you to sleep. It primarily is used in emergency c-sections when there is a medical issue with you and/or your baby.
Analgesics: Opioids (narcotics) help reduce pain. They can be given locally or regionally through a shot or IV (intravenous). This pain medicine can produce side effects, such as making you tired, nauseas, or light-headed. There also is a risk of the pain medicine getting into your baby’s system before they are born.
It is possible to receive more than one form of medicine throughout the labor process. You should have a plan in advance so you have an idea of what to expect. For instance, many medicines need to begin prior to active labor, or pushing. You also should have a backup plan with your doctor in case problems occur. Remember that medicines wear off over time, so talk to your doctor about how to treat ongoing pain if your labor is long.
Questions to ask your doctor
- What is the best pain management approach for my situation?
- Are there exercises I can do during pregnancy to prepare me for pain during childbirth?
- How early on do I need to get medicine, like an epidural?
- What are the potential side effects of medicine for my baby and me?
- Will I be able to move, feel, eat or drink if I get medicine?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.