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 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

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