Know your options for pain management in childbirth

Your pregnancy brings with it many choices. You pick a physician, a hospital, baby names, paint colors and the list of decisions doesn’t stop there. Making an informed choice about pain management during labor and childbirth should be at the top of your decisions list. Some of the pain management options discussed below are not available to everyone because of existing medical conditions and side effects. Your OB-GYN can help you determine what’s best for you and, at the very least, needs to know your preferences and expectations.

Natural Childbirth

Nursing staff at both Huntsville Hospital for Women & Children and Madison Hospital are experienced with helping women through natural childbirth, which is childbirth with no medications. Many women want to prepare for natural childbirth by relying on techniques such as relaxation and controlled breathing to manage pain. The best way to learn more about and practice these techniques is through a certified childbirth class. We have a variety of labor tools including birthing balls and birthing stools. With your physician’s approval, you can also labor immersed in water, called hydrotherapy. At Women & Children this can be done in your room’s bathtub. At Madison Hospital, our staff is happy to accommodate hydrotherapy but you will need to bring your own inflatable tub. It’s important to understand that circumstances may arise during labor that lead to a determination by your care team that hydrotherapy is not a safe option.

Nitrous Oxide (laughing gas)

Nitrous oxide is a colorless, odorless gas that’s mixed with oxygen and used to help pregnant women cope with labor pains during active labor. It does not numb any part of your body and doesn’t reduce pain like a narcotic, but it can reduce anxiety and provide a disassociation from your pain. This means you might still feel pain, but you won’t be as bothered by it.

Patients inhale the gas through a mask placed over the nose and mouth. It is self-administered so women can use it as needed during labor, pushing, and after-birth repair. Nitrous oxide quickly leaves the body’s system in three breaths allowing laboring moms to walk, stand and use other labor techniques in combination with nitrous oxide.

Nitrous oxide has no negative effects on fetal heart rate and it does not affect breastfeeding or breast milk. It cannot be used if you are receiving pain medicine through an IV.

Epidural

An epidural is technique of using a catheter – a very thin, flexible, hollow tube – that’s inserted into the epidural space just outside the membrane that surrounds your spinal cord and spinal fluid. The catheter delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. This is a popular choice for women who don’t want to feel pain but also don’t want to feel medicated or “fuzzy” during labor and childbirth. With an epidural, you must stay in bed because it causes your abdomen and legs to feel numb. Before the procedure to place the epidural can begin, you will provide written consent, your physician must write the order, your nurse will start an IV to deliver fluids and your blood will be collected for lab tests. Some women may also need a urinary catheter.

IV Sedation

Pain medicine can also be given through an IV. Typically this method of pain control causes the mother to feel sedated because the medicine distributes throughout the entire body. Women who use IV sedation must stay in bed to labor because they are at risk of falling.

By Jade LeCroix, RN and Renee Colquitt, CRNP

Jade LeCroix, RN Jade is the Director of the Labor & Delivery Unit, Antepartum Unit and OB/GYN Emergency Department at Huntsville Hospital for Women & Children.

Renee Colquitt, CRNP, NNP-BC Renee is the Director of Perinatal Services at Madison Hospital.