Tuesday, 06 January 2009
by Nurse Jenna
Though a baby can bring some of life’s greatest joys, having a baby is painful. People experience pain differently and have different pain tolerances, so it is not surprising that they also have different plans for how they choose to cope with pain of childbirth. Some women have an idea before they go into labor about the type of pain management they want, while others decide to “play it by ear.” Regardless, knowing what pain relief methods are available in advance is useful, even if you ultimately decide against it.
If you are planning to deliver in the hospital, you will usually be asked what your pain management plans are when you are being admitted. This does not mean the decision is final, or that you cannot alter your original plan. It just helps your doctors and nurses have an idea of how to best help you have the delivery you would like. Some women want an epidural as soon as possible, others choose to have a natural birth. Neither is right, or wrong, but you will get better care if you keep your providers informed of what you think you want to do.
However, you should go in knowing that there is a point in labor where it is “too late” to get an epidural or IV narcotics. If delivery is imminent, there may not be time to change your mind. It is unusual to miss the window of opportunity for an epidural with a first baby, but it can happen and with subsequent pregnancies, labor can frequently progress too quickly for an epidural placement.
Many women choose natural childbirth and have their babies without any pain medication. Some things to help alleviate the pain without pharmacological intervention include walking and frequent position changes. Breathing techniques and repetitions of a word or phrase can be helpful for relaxing and putting your mind in a more meditative state. A bath, shower, or massage can also provide some distraction and ease muscle tension.
Sedatives are sometimes used in early labor to women get rest and there is the possibility of being sent home on a sedative and/or narcotic for what is termed “therapeutic rest.” This enables you to get some sleep so that you have energy when you are in more active labor.
Narcotics can dull the sensation of pain in labor, but it does not eliminate it entirely. Medication is usually given through an IV, but also can be given in the form of an injection. Often women drift off to sleep in between contractions after receiving narcotics, but the medication is not strong enough to enable them to sleep through the contractions. Narcotics can cause respiratory depression in the baby if a woman delivers shortly after their administration, so they are more commonly used when delivery is not yet foreseeable.
An epidural is when medication is inserted through a needle into the epidural space of your back in between your spinal bones. A thin, plastic tube is left in place after the needle is removed. The medication continues to infuse through the tube in your back until after the baby is born. The medication numbs the nerves to your abdomen, pelvis, and legs. Though epidurals work well to relieve the pain of contractions, they do not eliminate the pressure sensation as the baby moves down. This pressure can also be very uncomfortable, but it enables a woman to feel and use the muscles to push the baby out. Epidurals are most often placed during active labor.
What type of pain management did you/will you use in labor? Did it go as planned?