Comfort Measures and Pain Relief During Labor

For some lucky women, labor is quite manageable. For others, it can be very uncomfortable and even painful — but it doesn't have to be. There are many ways to make yourself more comfortable during labor, from relaxation to medication, so you have lots of choices. You can learn and practice natural pain-relief techniques prior to labor; then, if needed, you can always add some form of medication, such as an epidural, as labor progresses. You've probably been reading up on what to expect in your 9th month, and as you learn more, you'll also want to weigh the benefits and risks of each approach to labor pain management.

No two labors are the same, and you can never quite know how you will experience and react to the pain of childbirth. Here, we'll show you some nonmedical techniques that might help keep you comfortable during painful labor and delivery, as well as explain the different types of medication you can opt for.

Nonmedical Pain Relief

• Relaxation techniques. Childbirth educators, nurses, and women who've used this approach recommend it more than any other as a noninvasive way to reduce muscle tension and pain in childbirth. You can learn more about progressive body relaxation (taking a tension-reducing “walk” through your body) ahead of time so you'll be comfortable using it during your labor.

• Massage. Have your partner massage your arms, legs, or back during labor to help you relax and to decrease tension and pain.

• Rocking. Spend as much of your labor as possible in a rocking chair, gently moving back and forth as you breathe and relax.

• Walking. Even simply pacing back and forth beside your bed can help provide labor pain relief while helping your contractions become stronger and more regular.

• Changing positions. Don't stay in the same position for more than one hour, and don't lie flat on your back. Instead, try sitting up in your bed or chair, lying on your side, squatting or rocking on a birthing ball, or leaning forward over the back of a chair or your bed.

• Hydrotherapy. Try sitting in a shower with a jet spray against your back, or lying in a whirlpool tub. Water can help create a calm environment, ease pain, and relieve stress. Not all birthing centers or hospitals have shower or tub facilities in the rooms, so make arrangements beforehand if you are interested in this method.

• Application of heat or cold. A heating pad or ice pack placed against your back can reduce muscle tension, improve circulation, and numb pain.

• Focused breathing. A specific pattern of breathing can help keep you relaxed and help you learn how to breathe through contractions. Focused, or patterned, breathing can be faster or slower; or may involve taking deeper or lighter breaths. Try to breathe in through your nose and out through your mouth, and ask your partner or support person to follow your lead.

• Music. Make sure you have your favorite, relaxing songs loaded up on your phone, tablet, or laptop. Don't forget your headphones or earbuds for when you may want a private moment alone.

Types of Pain Medication During Labor

Pain management during labor comes in different forms and methods of delivery, so you'll want to learn a little more about each before you decide which may be best for you. Your options may change depending on whether you'll be having a vaginal or cesarean delivery, or if circumstances change during your labor. Pain medications generally fall into two categories: analgesics, which lessen the sensation of pain; and anesthesia, which can block pain. The drugs can be systemic, affecting the whole body; regional, affecting a particular region of the body, such as the area below the waist; or local, affecting just a small area of the body.

Analgesic Pain Medications

Systemic analgesic medication is a form of labor medication that's often given as an injection or through an intravenous line (IV).

Pros:

• Decrease the sensation of contractions

• Provide pain relief without total loss of feeling or muscle movement

• Allow mom to stay awake

Cons:

• Do not totally relieve pain, but lessen the intensity

• May cause drowsiness, nausea, or vomiting

• May not be available within the hour before delivery

Effects on the baby:

• These drugs pass from your bloodstream through the placenta to the baby, and can cause the baby to be drowsy.

Epidural During Labor

An epidural is a “regional block” that is injected into the spinal area. A tiny catheter is inserted into the back, just outside the spinal column. Then, one or more anesthetic and analgesic drugs can be administered through the catheter as needed.

Pros:

• Usually provides total pain relief to the lower half of the body

• Can be used for vaginal births or cesarean births

• Allows mom to be awake and alert throughout labor and birth

• Allows mom to be able to rest if labor is long

Cons:

• Procedure takes about 20 minutes and another 10 to 20 minutes for the anesthetic to take effect

• Can increase the length of labor by decreasing the quality of uterine contractions

• Blocks motor nerves, so mom will not be able to move her legs or get out of bed

• May lower mom's blood pressure, so it must be monitored continuously

Effects on the baby:

• Usually none, but if the mother's blooad pressure drops, the baby's heartbeat can also be affected

Nitrous Oxide

One of the alternatives to an epidural, nitrous oxide is an inhaled analgesic gas you may have also heard called “laughing gas.” It is self administered through a mask, allowing you to breathe the gas during a contraction and remove the mask when it's finished.

Pros:

• Quick, easy, and safe

• Can be started or discontinued quickly and easily

• No effect on labor progress or quality of contractions

• Mom remains alert and able to move around

Cons:

• Some women may feel drowsy, lightheaded, or euphoric

• Some women find it's not very effective in decreasing pain

• Can cause nausea

Effects on the baby:

• No significant adverse effects, as the gas is cleared from the mother's body within a few breaths after she stops inhaling it

Local Block

This type of pain relief for birth involves an injection of a numbing medication into the perineal area at the time of birth.

Pros:

• Allows the mother to be awake for the birth, and provides anesthesia for the episiotomy and subsequent repair

• Usually has no negative side effects

Cons:

• Does not help with discomfort of labor contractions

Effects on the baby:

• None

General Anesthesia

An IV is administered with drugs to make the mom drowsy, which is followed by the administration of a gas that is inhaled through a mask or breathing tube, causing mom to lose consciousness. This is only administered at the time of birth.

Pros:

• Can be administered quickly, so it's beneficial if any unforeseen complications arise

• Mom is not awake and does not feel pain

Cons:

• Mom is asleep for the birth

• Can cause nausea and vomiting after awakening

Effects on the baby:

• These drugs pass quickly through the mother's bloodstream, through the placenta to the baby, so the baby may become drowsy and require help breathing after birth

It's important to keep in mind that every woman's labor is unique. You can't anticipate in advance how much discomfort or pain you'll experience during labor or how you'll respond to it. Many factors influence what your pain relief or medication needs will be, so discuss these options with your healthcare provider beforehand so you'll be prepared. For more information, support, and advice, check out our other guides to giving birth and starting your new family life.