Pain Relief During Labor

Epidural

Another option might be an epidural. Well over half of all pregnant women in the United States have epidurals now. That's more than double the number from 10 years ago, and the procedure is becoming increasingly popular as the techniques for administering epidurals improve.

If you choose to have an epidural, the anesthesiologist will ask you to sit up or lie on your side. She will first clean off a spot on your back with an antiseptic solution, then inject a local anesthetic under the skin in your lower back. Then she'll insert a thin tube (catheter) through a larger needle between the bones of your spine and near the spinal cord. The needle is removed, leaving the tube in the epidural space to deliver a local anesthetic continuously or every couple of hours or so.

In the past, epidurals were so powerful that they usually rendered women numb in the legs and pelvic region, making it impossible to move around and difficult to push when it came time to deliver the baby. Anesthesiologists now use a diluted anesthetic, usually combined with a low dose of an opioid drug, to relieve pain while leaving you less numb. In some hospitals, you might even be allowed to walk. Most epidurals won't prevent you from pushing when your baby is ready to make his appearance.

Combined spinal epidural (CSE). This option is gaining popularity for labor. It is administered much like an epidural. After a clean space on your lower back is prepared, a needle delivers an opioid and local anesthesia into the spinal fluid for immediate relief; a catheter is then put in the epidural space to deliver opioids and local anesthetics continuously.

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