Pain management in the delivery room

What are your plans for managing pain in labor? What is the doctor’s policy toward pain relief (epidural or narcotics) in labor? Ideally, by the time you reach the delivery room, you have discussed this choice with your doctor and may have included it in your birth plan. If not, you will be given choices for pain management during delivery.

• Narcotics – Some physicians will offer narcotics at the stage of labor. The medication will ease the intensity of the contractions but won’t take them away. Your partner might become sleepy or slightly “confused” while the medication is active. It is safe for mother and baby. However the baby may experience some of the sedating effects of the shot.

• Epidurals – An epidural is an injection of medication to numb the pain of labor. It is given through a plastic tube inserted into an area outside the spine-epidural space – where all the nerves exit. The medication will relief your partner’s pain without sedating her or the baby. The epidural allows medication to be administered either continuously through a pump or intermittently by injection through the plastic tube that was inserted initially. The epidural is removed once the delivery is complete.   

Epidurals are very safe and effective. An epidural is a coach’s best friend during labor. Your partner will feel better than she has during most of her pregnancy once the epidural is working. Of course, there are occasional side effects from the epidural. Some patients complain of a sore spot in their back afterwards, others have a small area of numbness in the leg or foot for a while. With the epidural insertion, your partner’s blood pressure might drop briefly or it may not take the first time, requiring a second insertion. 

Personally I have had an epidural for surgery and it was no big deal. My wife also had an epidural with each delivery. For someone who was really opposed to the idea before her first labor experience, on her third labor, she was walked in backwards, pointing to the spot she wanted the epidural placed. 

You need to talk with your practitioner about their policy toward pain management. Not every hospital will provide epidurals on demand. They might not offer them at all or only after your partner has reached certain dilation. You should check this out before selecting your “birth hospital.” 

In a follow-up newsletter, we will follow our patient and her partner through delivery. 

Good luck and enjoy the ride.

– Dr. Craig Bissinger