Now that you are pregnant, your excitement is probably growing as you anticipate welcoming your new little baby into the world. But despite this excitement, you may be a little [or even a lot] nervous about getting through labor first. Deciding whether or not to use medications during labor and delivery can be particularly nerve wracking for many moms-to-be. But you can lower your anxiety levels considerably just by becoming familiar with the types of medications that you may be offered during childbirth. Here is some detailed information about the various types of labor medications, their side effects, and the pros and cons of using them.
Epidural
The epidural is by far the most common type of medication given to women during birth. An epidural is actually a mixture of anesthetic medications [like lidocaine or chloroprocaine] and narcotics [like Demerol or morphine]. An epidural is administered through a catheter. This catheter is inserted in your back into the space surrounding the outside membrane of your spine. It helps to relieve labor pains by blocking most of the pain that you experience in your lower body. The epidural takes about 20 minutes to start working, but it allows for continuous pain relief while you are giving birth.
Pros :
The epidural blocks most child birth pains
It works for extended periods of time
You can easily control the amount of medication that runs through the epidural catheter
An epidural leaves you awake and alert for labor
Cons :
It is an awkward procedure and takes time to begin working
An epidural makes it necessary to have continuous fetal monitoring
You may lose your ability to stand or get out of bed for the rest of your labor
Epidurals can interfere with your ability to push, extending your labor
Occasionally, epidurals can cause your blood pressure to drop, decreasing baby’s heart rate
Very rarely, epidurals can cause severe headaches [if spinal fluid leaks during insertion of the catheter]
Spinal Block
Like the epidural, the spinal block is a mixture of anesthetic medications and narcotics. It is administered during the active stages of labor or just prior to a cesarean section. The spinal block works immediately to relieve pain as the medication is injected directly into the fluid in your spinal column. A spinal block provides total pain relief from the chest down for up to two hours.
Pros :
Spinal blocks allow for complete pain relief
A spinal block allows you to remain awake and alert throughout labor
Cons :
The spinal block procedure can be uncomfortable to have administered
A spinal block can cause loss of bladder control, necessitating a catheter
Spinal blocks can cause a decrease in your blood pressure, which may lower baby’s heart rate
A spinal block may interfere with your ability to push
Side effects can include itching, tingling, nausea, and lightheadedness
Systemic Medications
During labor you may also be offered various narcotics and tranquilizers to help you deal with any pain and anxiety that you may be experiencing. Narcotics help to dull your labor pains, but they won’t eliminate them completely. Tranquilizers won’t be helpful for your pain, but they can help to reduce your anxiety, allowing you to rest during labor. These medications are usually given intravenously or through intramuscular injection. They usually last between four and eight hours.
Pros :
These medications can reduce pain and relieve anxiety effectively
They may allow you to catch up on rest during the early stages of labor
Tranquilizers and narcotics can be administered easily, without the help of an anesthesiologist
They are less likely to slow labor
Cons :
Systemic medications can pass through the placenta and enter baby’s bloodstream, making him less active upon delivery
These medications may affect baby’s health, including his heart rate and ability to breathe
Side effects can be unpleasant and include dizziness, drowsiness, nausea, and itching
Narcotics are less effective on pain than the epidural or the spinal block
These medications may reduce your memory of labor and delivery
Pudenda Block
A pudendal block uses anesthetic medications to numb the area between the vagina and the anus. You may be offered a pudendal block if you have had an episiotomy or if a tear has occurred during labor. A pudendal block can also help reduce the pain associated with a vacuum-assisted delivery or a forceps delivery. A pudendal block lasts anywhere from several minutes to an hour.
Pros :
A pudendal block provides excellent local pain relief
The pudendal block rarely causes any side effects for mom or baby
Cons :
A pudendal block doesn’t relieve labor contractions
This medication can sometimes decrease your urge to push
Rarely, a pudendal block can cause your blood pressure to drop, which may interfere with your baby’s heart rate
There is a possibility of an allergic reaction with a pudendal block
