pain-relief choices

Traditional and alternative options for labor pain


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 ProsCons


 
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