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Your obstetric caregivers at MacArthur OB/GYN and labor nurses at Baylor Scott + White Medical Center at Irving want to help make the birth of your child a pleasant and safe experience for you and your partner. You should be aware of all your options for pain relief, or analgesia, in case you choose to make use of them during your labor. The purpose of pain relief is to help you have the most positive birth experience possible while maintaining safety for you and your baby.

PAIN RELIEF METHODS

Systematic Medications

  • Pain relief through an intravenous infusion (IV)
  • May not eliminate all discomfort but will diminish the discomfort
  • Effective in early labor
  • Safe for baby if not administered too close to delivery
  • May cause sleepiness, nausea, vomiting, or itching

Local Anesthetics

  • Medications injected by obstetrician into birth canal and vaginal area at time of delivery
  • Provide numbness or decrease sensation in the perineum or area between the vaginal opening and anus
  • Helps to ease pain of the stretching sensations felt at delivery
  • Allow for an episiotomy or a repair of a laceration in perineum to make more room for delivery
  • Administered just before delivery
  • Does not lessen the pain of contractions during labor

REGIONAL ANESTHESIA

Regional anesthesia is performed by your anesthesia provider. Regional anesthesia makes a part of your body less sensitive to pain. It includes epidural, spinal, and combined spinal-epidural analgesia. Regional anesthesia removes the sharp component of labor pain and greatly decreases the dull, pressure pain. This type of pain relief provides you with an opportunity to rest and gather the needed energy for the pushing stage of your labor. You will notice a loss of sensation or numbness in the lower half of your body, but the ability to move is mostly preserved. This allows you to push with less discomfort during delivery. The strength of the analgesia can be varied according to your special needs. Although your labor will not be painless, it should be much more comfortable. Some sensation must be preserved to allow you to push effectively. You will be evaluated by an anesthesia provider. Utilizing information obtained about your medical history and your obstetric provider, and in conjunction with your desires, your options will be discussed as well as the benefits and risks of each method.

Epidural Analgesia

  • The most common form of regional anesthesia
  • Performed while sitting or laying on your side
  • Your skin is cleansed with an antiseptic solution
  • A small area is numbed with a local anesthetic , which stings for a few seconds
  • After this you will feel pressure
  • A needle is guided and placed between the bones of your spine and slowly advanced until it reaches the epidural space, which is the space within the spine but outside the sac containing the spinal fluid
  • A tiny plastic tube, called a catheter, is placed through the needle
  • The needle is then removed and the catheter is taped to your back
  • Medicines will be injected into the catheter then connected to a pump to deliver pain medication continuously throughout your labor
  • After you deliver, the catheter is easily removed
  • The onset of pain relief occurs in 5-20 minutes and may last from 1-3 hours after delivery

Spinal Analgesia

  • This is performed in a similar fashion to an epidural
  • It is the most common method for a cesarean section
  • A smaller needle is used to enter the sac containing spinal fluid
  • A very small dose of medicine is injected and the needle is removed
  • This procedure involves a one-time dose pain relief lasts from 1-4 hours

Combined Spinal-Epidural Analgesia

  • Sometimes spinal and epidural anesthesia is combined in one technique
  • After the epidural needle is placed, a very thin spinal needle is placed through the epidural needle and the first dose of pain-relieving medicine is deposited into the spinal fluid
  • Then the spinal needle is removed and the epidural catheter is inserted for later use
  • This technique combines the rapid onset of spinal analgesia with the duration and flexibility of the epidural technique

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