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Pain Relief During Labor


A number of commonly used drugs can safely and effectively ease the pain of childbirth.



Despite the arguments in favor of natural childbirth, there is no intrinsic virtue in avoiding pharmacological pain relief if you feel you need it. Everyone has a different pain threshold, and what one woman will endure without much strain, another will find intolerable. In addition, every labor and delivery is different.






What is it?

Effect on you

Effect on your baby

Demerol

Demerol is the trade name for a powerful anagesic, meperidine hydrochloride. This is most effective when administered in one of two ways, either by a one-shot intramuscular injection, usually or slowly via an intravenous drip. This allows your practitioner to monitor its effects and increase or decrease the dosage as appropriate.
Demerol is not usually administered until labor is well established. Tranquillizers may be used with the analgesic to enhance its effect if a woman is very tense.

  • Demerol will make you drowsy but won't normally interfere with your contractions or- later-your ability to push.


  • Women react to Demerol in different ways. Some finding it relaxing, others, disorienting, which makes managing more difficult.


  • You may experience nausea and nausea and vomiting, a feeling of depression, and/or a drop in blood pressure.

  • This varies according to the strength to the dose and the timing.
    Your practitioner will keep the dose as small as possible.


  • Your baby may be drowsy and have difficult sucking.


  • In rare cases, a baby may need additional oxygen for a few hours to help her to breathe.

Spinal block

A spinal block, like an epidural, is an injection given in the lower back. The woman is asked to sit or lie on her side and a small amount of the anesthetic drug is injected into the spinal fluid; this numbs the lower half of the body. Although it starts to work quickly, its effects last only an hour or two, and it is not usually repeated. It is best suited for pain relief during delivery, when it can be used for a cesarean delivery or for the use of forceps or vacuum extraction.


  • A spinal block may cause a drop in blood pressure, which can be remedied by raising the legs to improve circulation, intravenous fluids, or medication. For this reason a spinal is not used if the mother is suffering from placenta previa or preeclampsia, or if the baby is in distress.


  • After delivery, you must remain on your back for up to 8 hours.


  • Some women experience.

  • A spinal can slow the baby's heartbeat. Therefore your baby will be monitored continuously.


  • Some babies born after a spinal are drowsy.


  • The breathing problems associated with analgesics and tranquillizers do not occur.


  • The baby may require forceps or vacuum extraction for delivery.

 

Epidural anesthesia

This is the most popular form of pain relief for labor. An anaesthetic drug is injected into the epidural space at the side of the spinal cord. A catheter is left in at the injection site so that more anesthetic can be given if needed. You are usually given an IV drug that will prevent your blood pressure from falling too low, then asked to lie on your side while the anesthetist inserts the epidural.
Some doctors now administer low doses anesthetic together with small doses of analgesic. This works more quickly than anesthesia alone and allows you to feel the urge to push and retain the ability to do so. Such so-called walking epidurals seem to combine the best ob both worlds-pain relief and active participation in delivery.

  • A standard epidural offers total pain relief to most women.


  • You will have no feeling from the waist down, which-depending on dose and timing-may make it harder for you to push in the second stage of labor. Some studies have shown that this increases the likelihood that forceps will be needed; others refute that.


  • You will be numb for several hours.


  • You may experience a violent headache for some days, usually the aftereffect of fluid leaking from the epidural space.

  • On rare occasions an epidural can slow the baby's heartbeat, so your baby will be monitored continuously.


  • Some studies have shown that babies born after an epidural are more likely to be drowsy.


  • The breathing problems associated with analgesics and tranquillizers do not occur.


  • The baby may require forceps or vacuum extraction for delivery.





PERCEPTIONS OF PAIN

Whether or not you want to take pain-relieving drugs, you can help yourself by being aware of and minimizing the psychological factors that make pain worse.


Choose a sympathetic but practical birthing partner. You are more likely to succumb to fear or self-pity if you are on your own, or if your companion is over-anxious on your behalf. Be aware of the power of ignorance in fostering fear. Find out as much as you can about what is likely to happen and take each stage as it comes. And be positive. Every pain is doing good; it is bringing the arrival of your baby closer.

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