Do you want to know more about pain medications for labour?
There are a lot of options to choose from.
The below list are likely available at your hospital, on top of all of the unmedicated options. Some are even possible at a home birth or birth centre.
1. Narcotics
What is it?
Narcotics in labour are commonly referred to as therapeutic rest. They are a great option for early labour, which means they can be available before you have an epidural. Narcotics are typically given as an injection in the upper thigh or through intravenous fluids. The most commonly prescribed narcotic medication is Morphine. Additional options can include Demerol and Nubain. They can take approximately 20-30 minutes to take effect.
Pros:
- Help take the edge off contractions
- Allows the labouring parent to get some rest and possibly sleep
- Lasts about 2-3 hours
Cons:
- Requires continuous external monitoring of your baby
- Is only available in early labour
- Not safe in active labour because the medication would not have the opportunity to wear off by the time your baby is born
- Will likely make the birthing person and the baby sleepy
- Doesn’t usually take away all the discomfort, which means you may need to use other comfort measures
- May cause nausea
2. Intravenous PCA
What is it?
Patient Controlled Anesthesia is a pain medication that you control through an Intravenous Pump. It is an alternate to regional anesthesia (epidural or spinal block epidural). If an epidural is not possible this is is usually recommended. Examples of a medical reason to not have an epidural would be a genetic bleeding disorder, unexplained seizures, or some spinal disorders. Typical medications offered this way are Fentanyl or Remifentanil.
Pros:
- Self administered, so you control how much medication you want and need
- Available during active labour, which means you can receive it at anytime
- Great option if an epidural is not available to you
Cons:
- Requires continuous external monitoring of baby
- Will likely make you feel drowsy & sleepy
- May cause nausea and/or itching
- Additional medications may be required to stay comfortable
- May affect baby’s heart rate and may increase your need for a c-section
- Baby may be sleepy at the time of childbirth, needing the support of a pediatrician or a respiratory therapist
3. Nitrous Oxide
What is it?
Nitrous Oxide is very similar to having laughing gas at the dentist. It is not free flowing, but is given through a mask and inhaled during a contraction. Nitrous Oxide is typically used in active labour because it is most effective for around 2-4 hours. Laughing Gas can also be used during the transition phase, helping to get to the pushing phase. If there are longer waits for an epidural, Nitrous Oxide can be given and is also helpful during vaginal exams if you are uncomfortable. Laughing gas can be requested if you need any repair for tearing once baby has been born.
Pros:
- Self administered, you use it when you need it
- Effects go away when you stop breathing the gas
- No extra monitoring required
- It does not affect your baby
Cons:
- Does not take away contraction pain completely
- May cause nausea
- Requires you to take deep and focused breaths
4. Sterile Water Injections
What is it?
This procedure can be really helpful if you are experiencing contraction pressure in your back. If you have a midwife, this may be a great option for you! A tiny amount of water is injected into four spaces of your lower back, which gives your body relief from back pain.
Pros:
- Onset of pain relief is very quick, between 30-120 seconds after receiving it
- Gives up to 2 hours of relief from pressure sensations in your lower back
- Can be given as many times as you need during labor
- You are able to walk around after receiving it
Cons:
- Procedure can be uncomfortable, similar to a bee sting
- The burning sensation can last up to 30 seconds before the relief kicks in
- Does not take away all labour sensations
5. Epidural
What is it?
An Epidural is the most common form of medical pain relief for labour. It is a combination of narcotic medication, placed in the lower back for constant pain relief. Once the epidural is administered, a birthing person often feels relief. Most side effects can be easily adjusted by the health care providers.
Pros:
- The most effective method of medical pain control
- The moment the epidural is administered, it is continuous
- Most hospitals will give a self administration button. As your contractions intensify you can use this button as an extra boost
- Ability to adjust dose up or down
- Takes away the sensation of pain and temperature
- May allow you time to rest
- May allow for some mobility in bed
Cons:
- Does not take away the sensation of pressure
- May experience a drop in blood pressure
- Might experience shaking or nausea
- May require a urinary catheter
- May take longer in the pushing phase
- Extremely rare complications that your anesthesiologist will consult with you
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