Understanding Medicines for Labor Pain

Learn about the medicines that can help with pain during labor and the possible risks of these medicines.

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As you prepare for the birth of your baby, you may be thinking about how to manage pain during labor. Some people hope to have a medicine-free birth. Others hope for the best, but plan for every possibility. Learning about your medicine options and discussing them with your doctor or midwife can help you feel more at ease as you get closer to your due date.

Everyone feels pain differently. Only you can decide how much you think you can tolerate. Pain during labor depends on many things. This includes the size of the baby, the position of the baby, the strength of your contractions, and the timing and stage of labor.

Medicines for labor pain are sorted into two groups. These are anesthetics and analgesics.

Anesthetics. These medicines block all feeling and pain.

  • Epidural. This is when medicine is injected into the lower part of your spinal cord to block pain signals in the lower abdomen and pelvis. You remain awake.
  • Local anesthesia (pudenal block). Similar to an epidural, this medicine causes the lower part of the body to feel numb. Medicine is injected into the nerves in the vagina, vulva, and perineum. You remain awake. This will reduce sensation in the vagina, vulva, and perineum. This does not affect discomfort from contractions.
  • General. This causes you to go to sleep. You won't feel any pain. This is only used in rare cases for cesarean delivery.

Analgesics. These medicines lessen pain but don't stop it completely.

  • Opioids, such as morphine, and non-opioids. These lessen pain in the whole body (systemic). These are given by a shot or through an I.V. You remain awake. Patient-controlled analgesia is also an option.
  • Nitrous oxide. This gas is mixed with oxygen and inhaled through a mask. While nitrous does not numb pain, it eases anxiety. It's also known as “laughing gas.” You remain awake.

What are the risks of medicines for labor pain?

Possible effects on you include:

  • Headache (epidural).
  • Lower blood pressure (epidural).
  • Nausea and vomiting (any type of medicine).
  • Itching (opioids and epidural).
  • Slowed breathing (opioids).
  • Slowed movement of the gastrointestinal system (opioids and general anesthesia).
  • Drowsiness (opioids).

Possible effects on your baby include:

  • Sleepiness (opioids).
  • Slowed breathing (opioids).
  • Trouble breastfeeding (very rare with any of the medicines used during labor).
  • Changes in body temperature (epidural).
  • Changes in neurological behavior (opioids).

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