pain-relief choices

Traditional and alternative options for labor pain

BY Angela Hynes

If you’re like most pregnant women, the pain of childbirth is at the top of your list of concerns. While several effective pain-relief methods, such as epidurals, are commonly used to ease labor pain, not enough research has been done on their side effects, according to the doctors and maternity caregivers who attended a symposium on the subject in New York. In addition, alternative methods for pain relief are underused, so you must ask for them. The experts at the symposium, sponsored by the Maternity Center Association and the New York Academy of Medicine, reviewed what is known about available labor pain-relief methods. Their findings were published in the American Journal of Obstetrics and Gynecology. Below is a rundown of those methods, with their known pros and cons.
   

MEDICATION CHOICES
      

What it is	When it’s used	Pros	Cons
Epidural or spinal (drugs given via catheter between vertebrae)	Can be given any time during labor, but many doctors wait until labor is well established	Virtually eliminates pain; dosage and timing can be adjusted	Might lengthen labor; can cause fever or headache
Injection of opioids	Throughout labor	Can be given more than once during labor	Not very effective for  pain; might make baby sleepy
Inhalation of nitrous oxide	Continuously or during contractions	Safe and effective; easy to administer	Can be difficult to time the application with contractions; not widely available

DRUG-FREE ALTERNATIVES

Warm baths of 1–2 hours	Best used after labor is well established	Might delay or reduce the use of drugs	Effects temporary; not always possible
Walking	Throughout labor	Can give the mother a sense of control	Not always an option
Sterile water injections for back pain	Throughout labor	Inexpensive; can delay or prevent the use of drugs	Slightly painful to administer; pain relief is temporary
Touch and massage	Throughout labor	Can be done by loved ones	May not alleviate severe pain
Doula or other consistent, nonmedical labor support	Throughout labor	No negative side effects	Usually requires advance planning; may not be covered by insurance