Have a Lovely Labor Day

Buh-bye, pain

They don't call it labor for nothing, but there are more ways than ever to manage that pain. And it's a good idea to explore them before you're in the throes: "If anything is predictable about labor, it's that it's unpredictable," says William Camann, M.D., director of obstetric anesthesiology at Brigham and Women's Hospital, in Boston. Know your options -- and keep an open mind.

Relief without meds

  • Relaxation "The most important thing to try and keep relaxed during labor is your mind," says Stacey Rees, a certified nurse-midwife in Brooklyn. When you fear pain, you tense up, which makes the pain worse and causes you to tense up even more.
  • Moving around Walking, swaying, changing positions, and rolling on a birthing ball can ease the pain and help labor progress by putting the force of gravity to work on your behalf. "If you have back labor, for example, you'll probably find your way to your hands and knees, which can relieve pain by getting the baby to rotate," says Eileen Ehudin Beard, a certified nurse-midwife and senior practice advisor for the American College of Nurse-Midwives.
  • Breathing Whether you're hee-ing or haa-ing, panting or inhaling deeply, as long as you focus, you'll find relief.
  • Massage Summon your partner to apply gentle counterpressure on your back, rub your swollen feet, or massage your temples to distract you.
  • Hydrotherapy Birth pools, big tubs that allow you to immerse yourself, are more and more common in birth centers and hospitals alike. The warm water is soothing. "And the buoyancy helps lighten the pressure," Rees says. "We call it the midwives' epidural."
  • Sterile-water capsules To relieve intense back pain, some midwives offer these, which are injected just under the skin near the sacrum. The procedure causes intense stinging at the injection site, but that subsides in 30 to 45 seconds, providing you with pain relief for up to two hours.

Relief with meds

  • Epidural It's given through a slow, continuous drip and works in 10 to 15 minutes. Most hospitals use patient-controlled epidural anesthesia, which allows you to press a button for more. You should still feel enough pressure to be able to push. It's very rare that you'll miss the window of opportunity to get an epi, especially if this is your first baby, Dr. Camann says. Unless your little one is already coming out, it's not too late! A very small percentage of women with blood-clotting disorders or scoliosis, or who have had back surgery, may not be candidates -- or the epi simply might not work as well for them. But for the vast majority, the procedure is A-OK. Contrary to what you might have heard, getting an epi doesn't put you at a higher risk for C-section, but it does add about an hour to labor.
  • Spinal and combined spinal-epidural A spinal block, known as a spinal, is a onetime injection into the spinal fluid in your lower back. It works in seconds and leaves you numb from the waist down for about 45 minutes. It's standard protocol for most elective C-sections. Sometimes doctors do a spinal-epidural combo for women who are far along in labor.
  • Opioids When an epidural isn't possible, some moms-to-be opt for painkillers such as Nubain, delivered via IV or IM (intramuscular). Unlike spinals and epidurals, this kind of medication can make you drowsy and nauseated. Also, doctors won't administer them too late in the game. "When used close to delivery, opioids may also make the baby sleepy," Dr. Camann notes. "That can make it harder to breastfeed."

Originally published in American Baby magazine in 2011. Updated in 2014.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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