Labor and Pain ReliefheadingContent

Posted on December 05, 2014

pregnant woman laying in hospital bed with legs up, rubbing her stomach, and lamaze breathingPregnant ladies wish for labor because they are uncomfortable, especially near or after 40 weeks of carrying a baby (defined as full term).  On the other hand, women fear labor because of the anticipated pain.

As an obstetrician/gynecologist, I have personally witnessed painless labor which – having had a baby myself – I consider a wonder of nature.  About 1% of women experience almost no pain during labor. These women typically present in labor with vague complaints such as “not feeling well”, “pressure”, or “something leaking”. When they are found to be in the advanced stage of labor most of these women are surprised to see that they are in labor at all.

For the remaining 99% some pain is felt. Conservative approaches to labor pain management include techniques such as Lamaze, Hypnosis, the Bradley Method and other practices which teach the brain how to deal with labor pains. Many women find these methods highly effective. Schedule IV narcotics are another option. The Schedule IV narcotics are given every few hours. For women in severe pain, an epidural is often given. Epidural is a powerful numbing agent given through the spine.

Epidural anesthesia is very safe and usually very effective, allowing a majority of women a much more pleasant labor experience. Complications are rare with the most common complication being inadequate pain relief.  There are some misconceptions, however, about this anesthesia.

  1. Epidural increases the risk of Cesarean Section. This is not true. Numerous studies have shown that although an epidural increases the length of labor, especially the active “pushing part”, epidural anesthesia does not increase the Cesarean Section rate.
  2. Epidural increases the risk of permanent back pain. This is not true. Studies have shown there is no difference in back pain between women who have had epidurals versus women who have not.
  3. Epidurals cannot be administered until a cervix is dilated 4 or more centimeters. This is not true. Studies have shown that it does not matter when an epidural is given, as long as the patient is in actual labor.
  4. Epidurals are painful to administer.  Also not true. Local anesthetics are injected first so that the actual epidural administration is often completely painless.

In conclusion, not all women need pain management during labor, but for the women who do, there are numerous safe and effective options.  Pregnant women should remember to discuss their preferences with their obstetrician before their due date.