The amount of discomfort women feel during labor and delivery varies from patient to patient and from one birth to the next. Some women do very well with techniques such as Lamaze (often called "natural" childbirth because little or no anesthesia is used). Most need more help, and prefer a combination of approaches. Depending upon your labor pattern, labor progress, medical history, and your baby's condition, additional pain management might include:
- Local anesthesia: You remain conscious and receive an injection of local anesthetic to numb your perineal area (between the vulva and the rectum) in preparation for delivery.
- Epidural analgesia: A type of regional pain relief in which pain-relieving medication is injected into the space around the lower spinal cord. You remain awake, feel less discomfort, and may even be able to walk.
Epidural analgesia is one of the most effective forms of medical pain relief during labor. The "walking" epidural involves continuous injection of a very low concentration of local anesthetic and narcotic medicine that eases the pain of contractions without causing weakness.
The vast majority of women in labor prefer to have epidural analgesia because of the excellent pain relief it provides. Epidural analgesia doesn't sedate the mother or baby and has a long history of safety for both.
- Epidural Patient Controlled Analgesia (PCA): During labor, a continuous infusion of medicine is dictated by the mother's ability, giving a small, supplemental dose when needed.
- Spinal analgesia or anesthesia: This is similar to epidural injections, but its effects are felt much faster because the medicine is given directly into the fluid that surrounds nerves in the spinal area. Both local anesthetics and narcotic medicines are injected for pain relief or for anesthesia. You may feel numb and will need help in moving during the delivery. Spinal anesthetics are mostly used for delivery by cesarean section or when the use of forceps is necessary for vaginal delivery.
