Pain Relief in Childbirth

Preparation in life is essential, especially when it comes to preparing a birth plan well before the time comes. Being informed of all of your options, along with the positive and negative side effects, helps you to make the best decision in advance for you and your family. Bayhealth Anesthesia Specialist Akshatha S. Kamath, MD, shares about the use of epidural anesthesia during labor and why you might consider it.

1. Understand your pain relief options in advance. There are different options for the type of experience a woman would like to have in childbirth. It’s best to have a first choice and a back-up plan if it is needed in a more emergent situation.
   
   • Labor epidural or a continuous spinal anesthesia — where a thin plastic catheter tube is placed near the nerves that carry pain signals to the spinal cord. This provides the most effective type of pain relief during labor. Generally safe with minimal side effects if timely addressed.
   • Nitrous Oxide (NOX)—a gas and oxygen mixture—is administered through inhalation. It’s often referred to as “laughing gas” and quickly decreases your awareness of labor pain. It can be given any point during labor. This is uncommonly done in the US due to multiple reasons.
   • TENS (Transcutaneous Electrical Nerve Stimulation) device—is a small device that creates low-voltage electric impulses—causes muscles to relax and distracts from the pain of contractions.
   • Pudendal block—an injection of numbing medication in the cervix area—can reduce the pain while delivering your baby. This does not help throughout the labor and is limited use only.
2. While there are risks involved, they are rare. Statistics from the Society for Obstetric Anesthesia and Perinatology (SOAP) state that serious risks from epidurals and spinals rarely occur ex: blood collection/hematoma in the spine causing paralysis (1 in 750,000 to 1 in a million). Minor risks include bad headaches (1 in 500), failed pain relief (1 in 10 to 1 in 50) and complications from too much medication (1 in 4,000 to 1 in 5,000).
   
   
3. The benefits may outweigh the risks. If a mother has already received an epidural, it makes it a seamless process with less risks if a cesarean delivery becomes necessary. Additional, stronger numbing medication can be administered through the catheter that is already in place, which can be used for anesthesia should an emergency Caesarean- section be necessary. This helps avoid the need for general anesthesia which would require an endotracheal tube inserted down the throat and would put the mother to sleep completely—when done in an emergency, it can create further risks of its own.

Overall, it’s important to consult with your own OBGYN or midwife about all your options. Your medical history, your personal preferences, and your questions all matter. You can receive the answers you need to rest assured that you’ll be making the best decision for you and your family.

Visit Bayhealth.org/Maternity-Obstetrics for resources to find a midwife or OBGYN and start your birth planning today.

Visit SOAP.org/Information-For-Mothers (Society of Obstetric Anesthesia and Perinatology) for a helpful resource in making an informed decision regarding the options of anesthesia.