Many types of medication can ease pain during labor and delivery. Epidural and spinal blocks are common choices — but you have other options, too.
Work with your health care team to make the best decision for you and your baby.THIS MODALITY IS CAREFULLY SELECTED FOR PATIENT AFTER ASSESING ALL RISK FACTORS.
Epidural block plus spinal
An epidural block uses one or more pain medications called anesthetics injected via a catheter into a small space outside the spinal cord in the lower back (epidural space). This allows for repeated or continuous administration of medications. Your health care provider will discuss with you the best time to request an epidural during labor. You might not be able to have an epidural if you have had major surgery in your lower back, have low blood-clotting factors, have an infection in your lower back or are on certain blood thinners.
Advantages :
alleviates most pain in the lower body without significantly slowing labor.
awake and alert but you will still feel pressure and some stretching during delivery.
A combined spinal-epidural block, which takes effect quicker than does an epidural and has lower doses of anesthetic medications, might leave you with more muscle strength.
Cons
You could experience an inadequate or failed epidural.
An epidural might decrease your blood pressure, which might slow the baby’s heart rate.
You could develop a fever or itchiness or experience postpartum soreness in your back.
Rarely, you might develop a bad headache.
Even if you have a combined spinal-epidural block, sometimes called a walking epidural, you will likely not be able to walk during labor.
Local anesthetic injection
Description
A local anesthetic might be used to quickly numb the vaginal area if you need an incision to extend the opening of the vagina (episiotomy) or repair a tear after delivery. The medication is injected into the area around the nerves that carry feeling to the vagina, vulva and perineum.
Pros
Local anesthetics temporarily numb a specific area. Negative effects for mother and baby are rare.
Cons
Local anesthetics don’t relieve the pain of contractions. An allergic reaction is possible. Rarely, injecting local anesthetics into a vein might produce a toxic reaction, affecting your central nervous system or heart.
Pudendal block
Description
A pudendal block might be used shortly before delivery to block pain between the vagina and anus (perineum). It can also be used to relieve pain during the repair of a tear after delivery. The anesthetic is injected into the vaginal wall near the pudendal nerve and takes effect in 10 to 20 minutes.
Pros
A pudendal block relieves pain in the lower vagina and perineum for up to an hour. Negative effects for the baby are rare.
Cons
A pudendal block might not work or might affect only one side of the perineum. An allergic reaction is possible. Rarely, a pudendal block can cause an infection at the injection site, and injecting the medication into a vein might affect your central nervous system or heart.
Nitrous oxide
Description
Nitrous oxide — an odorless, tasteless gas — is an inhalation analgesic that can be used during labor. You administer the anesthetic gas using a hand-held face mask. Nitrous oxide takes effect within a minute.
Pros
Nitrous oxide can be used intermittently or continuously during labor. You control the amount you use. You’ll be able to walk during labor. If you become too drowsy, you’ll be unable to continue holding the mask to your face and stop inhaling the anesthetic — a built-in safety mechanism. The effects quickly wear off when you remove the face mask. Nitrous oxide is believed to have little effect on the baby.
Cons
Nitrous oxide doesn’t eliminate pain. To experience relief, you’ll need to time inhalation of nitrous oxide so that it occurs about 30 seconds before you expect each contraction. You might experience nausea, vomiting, dizziness and drowsiness.