Painful labor has been a part of the human experience since the dawn of time. Every culture has attempted to explain the pain of giving birth, sometimes with interesting results. Explanations are often based on religious views, societal customs, or an understanding of biological functions. The fact remains, it hurts to have a baby.

Women going through the labor process can experience pain in a variety of ways. Some have excruciating pain while others only have mild discomfort. It is not clear why labor is more intense for some than for others. Some factors we know. Pain is more likely to be greater if a woman is young, or if she is going through labor for the first time. Pain will likely be greater if the baby is large or the mother has gained excessive weight during the pregnancy. Interestingly, women who experience severe back pain with menstruation are also more likely to have painful labor. The use of the drug pitocin, which is used to help initiate or strengthen contractions, also correlates highly with more intense and painful labor.

When it comes to pain relief in labor, expectant moms fall into three categories:

• Some are absolutely sure they want any and every pain relief option available.
• Some are not yet sure of their options, or worry how those options may affect their baby.
• Some prefer to give birth the ‘natural way’ without artificial pain relief.

Some women seem to be able to control the pain of their contractions with relaxation techniques, controlled breathing, and family support. Others just want something “to knock me out,” and would be happy to sleep through the entire labor process.

No matter what the plans for labor are, it is helpful to be aware of pain relief options before labor begins. Labor is hard to predict. It could turn out to be quick and relatively painless, or it could last far longer than expected. Every mom should be open to the possibility of needing additional help should the pain become more than she can tolerate.

Epidural anesthesia is the choice of many women and their physicians for labor and delivery. It is a safe and effective way of alleviating labor pain. An Epidural is a ‘local anesthetic’ placed into space outside of the spinal canal called the epidural space via a small catheter taped to the back. It has a wonderful advantage in that it lets a woman experience her birth while alleviating most of her pain. As with any option in life, there are pros and cons to epidural use.

Let’s look at the benefits first:

• It provides great pain relief.
• It can allow a woman time to rest and regain her strength.
• The labor process seems calmer. Family is more at ease and less fearful.
• In some cases, it can speed up the labor process.
• Should there be a need for an emergency C-section, the anesthesia is in place.

Some of the cons:

• It may not be as effective in removing the pain as the woman may have wished.
• There is the risk of a spinal headache, possible low blood pressure, or fever.
• The woman may be confined to the bed since walking would be impossible.
• It may prolong labor, especially if given too early in labor.
• If given too early, it could increase the need for a C-section or forceps use.

How is an epidural given? Your physician will probably wait until your cervix is 3 to 4 centimeters dilated before asking the anesthesiologist to place your epidural. You will be asked to sit on the side of the bed and lean forward, arching your back so it opens the vertebral spaces as much as possible. The small of your back is then washed with a betadine scrub. After numbing the skin, the anesthesiologist will place the epidural needle between your vertebrae into a space called the epidural space just outside of your spinal canal. It is very carefully placed and usually timed between contractions. A small catheter is threaded through the needle and the needle removed. This usually takes less than a minute. After giving a test dose of the medication, the anesthesiologist will connect the catheter to a pump at the side of your bed, which will give you a continuous dose of anesthetic to block the sensations of pain. Within 10 to 15 minutes you will be much more comfortable.

There are a few things you will be giving up along with the pain. Your mobility will be hampered. It’s hard to walk when your legs feel like spaghetti. You may need help rolling over or holding your legs up when you begin to push. Some women are not able to urinate easily and require the placement of a catheter in the bladder. Now will be a good time to catch up on your sleep. You will need your strength when it comes time to deliver your baby.

There are many questions frequently asked by pregnant women about epidurals and other anesthetic options. Answers vary and cannot all be covered in an article of this length. It is important that you be informed and have an opportunity to discuss your options. Memorial Hospital of Carbondale offers an ‘Epidural Class’ twice a month. This provides an opportunity to review in greater depth the benefits and risks of this pain relief option. For a class schedule, call 618-549-0721 ext. 65141.

The purpose of all forms of pain relief is to give you a positive birth experience. There is no greater moment in a family’s life than the addition of a little one to the circle. The better prepared you are, the more rewarding it will be.