There are likely few women who reach their childbearing years never having heard a woman recount a story about childbirth. Delivered in the right tone with the best of intentions, these accounts of childbirth don’t have to resemble horror stories at all. Birth is a beautiful and life-changing experience, and embracing it as such can make for a much more pleasurable experience for Mom and baby. Some call it a rite of passage and others think it’s just poor behavior to share these life experiences, but most women enjoy sharing their birth stories with one another and passing on advice they’ve learned through experience. Mothers who open themselves up to absorbing such knowledge have the upper hand and should savor the wisdom.
In 2010, there were 3,999,386 babies born in America, per the National Institute of Child Health and Human Development. That’s a lot of laboring! Some of these babies were born to mothers via cesarean sections, some vaginally with the use of pain medication and some without. Regardless of the route of delivery, pain management principles apply. Mothers can take advantage of many different avenues toward the treatment of pain during labor and childbirth. Some will take the edge off, some will take all sensation away entirely, some will help mothers to distract themselves from the pain that is present, and some will help mothers to work with the very purposeful pain that childbirth brings.
There are pros and cons to every method. Having a C-section obviously requires anesthesia. Some women will require general anesthesia which puts them completely to sleep during their surgery. It’s typically administered through breathing or an IV. Sometimes Moms can choose between a spinal or an epidural—both forms of regional anesthesia—for cesareans and should be aware of the side effects and benefits of each. The beauty of birthing today is that mothers can choose for themselves which pain management option suits them best.
1. The Epidural
The epidural is the most commonly used form of pain relief across all options. What to Expect notes half of all women who give birth opt for an epidural. An opioid drug, like morphine, is injected into the spinal column by way of a needle and catheter. Many women are fearful of the needle used during this procedure. While it is large, the sensation felt by administering it is actually quit minimal since the area is numbed topically beforehand. Epidurals usually contain a combination of local anesthetics, like lidocaine, and narcotic opioids, like fentanyl.
While epidurals can be given at any stage during labor, many organizations encourage mothers to wait until active labor begins. The Huffington Post recently claimed that early administration of epidurals may delay labor or make a C-section more likely to rest, citing a research review of nine studies that showed no such support. Epidurals are administered between contractions and require moms to curl forward so the spinal column and vertebrae stick out for increased visibility. Epidurals completely remove all sensation and feeling below the waist.
Having no lower body sensation means a bladder catheter must be inserted to keep draining urine. Mom is then restricted to bed. This may be one of the contributing factors to why epidurals are known to slow labor, since movement and the use of gravity to bring the baby down are proven to speed up the process. Also, a lack of feeling in the lower half of the body means moms are unable to feel when they have the urge to push. As a result, they generally need to be coached by the attending nurse or care provider, which has been shown to lead to tearing more often than when moms simply push as they feel the need to, says Dr. Rachel Reed of Midwife Thinking.
There are side effects with the use of epidurals. One of the most commonly reported is nerve damage in the back or spine. This can cause tingling sensations beneath the skin, itching that cannot be relieved with scratching or medication, burning deep in the muscle tissue of the back, and more. Some women may experience numbness that reaches upward into their chests. In these instances, panic attacks and heart-pounding sensations have been reported. Many moms report being groggy after the use of epidurals and having a loss of appetite, blunted levels of oxytocin that can contribute to the development of postpartum depression, increase the risk of needing Pitocin, and more. They also present side effects to the baby, such as:
- Difficulty latching when breastfeeding
- Effects that come with exposure to opiates
- Fetal brain bradycardia
- Poor oxygen supply
- Low Apgar scores
2. IV Medication
Intravenous medication for pain relief is becoming more common among mothers who want to forego the risks of an epidural but still feel they need pain relief to get through childbirth. The brand of medication used varies, but they are all narcotics, from Demerol to Stadol. These drugs also being opiates, the same risks apply that do with epidurals. One of the benefits to IV pain medication is that it can be stopped at any time if a reaction would occur. These drugs are usually re-administered every two, four, or six hours after they begin to wear off. The side effects of IV pain medications include:
- A loopy feeling , like drunkenness
- Poor Apgar scores in newborns
- Heart decelerations or poor oxygen intake in newborns
- Impaired breastfeeding on baby’s behalf
3. Nitrous Oxide
This option is less common in the United States than other nations, but it is picking up steam. Often referred to as laughing gas, nitrous oxide is inhaled and can quickly be cut off if need be. The drug is reported to take the edge off of labor, but pain is still present. In turn, fewer restrictions are imposed on the mother than are with epidurals. It may make some women giddy to the point that their labor experience seems like an altered state of reality. It may be a better option for women who want to avoid impeding hormonal responses during labor or breastfeeding issues that are commonly reported with other pain relief methods. The likelihood of adverse events is higher is individuals who are MTHFR (methylenetetrahydrofolate reductase) positive and should be avoided by them.
4. Natural Birth
The choice to go without pain medication is a brave one and certainly doesn’t mean those mothers have to go without pain management. Water births are becoming more common for this very reason. Even birth centers and hospitals are now encouraging women to spend some time laboring in bath tubs due to the soothing effects the deep water has on some of the pain of contractions. Other tips for coping with pain during natural childbirth include:
- Counter-pressure on the hips and lower back
- Rocking curled over a birthing ball
- Controlled breathing practices
- Hiring a doula
- Water pressure
- Essential oils
- Use gravity to help baby descend
- Walk and change position often
- Stage a relaxing environment
- Sterile water injections
- TENS units
Regardless of which method appeals most to each mother, the benefits and side effects of every pain management method should be considered. Even mothers who are planning a natural birth should consider whether they would want a spinal or epidural in the event that they would need a cesarean section. Keep in mind that CNN notes only around 3 percent of Cesareans are really emergency situations that require the surgery. If you go into birth informed, you can’t go wrong.