Delivery time: Steps to pain management
What are your options when it comes to pain management during labor?
These are always discussed in Spectrum Health’s childbirth education classes, where educators and providers want parents to be informed and make decisions that serve them well.
I like to compare pain management options to a ladder.
Picture a ladder going from floor to ceiling—in our classroom, it’s about a 12-foot ceiling—and then ask the question: “If you climb on the first rung of the ladder and fall off, what are the potential concerns? What are your chances of getting hurt?”
Most moms answer, “Pretty slim.”
I jokingly say you could trip walking down the hallway, like I can, but most people don’t.
The first rung of the ladder is comparative to the non-medicated pain options you have available for labor:
- Using the birth ball or peanut ball.
- Having a doula.
- Setting the room atmosphere to your comfort.
- Relaxation techniques.
- Hydrotherapy—using the tub.
- Visualization or HypnoBirthing.
- TENS unit.
- Breathing patterns.
Much like falling off the first rung of the ladder, these pain management options don’t have any risk to them.
Rung No. 2
If we climb to the second rung of the ladder, the equivalent option in labor would be nitrous oxide, commonly known as laughing gas. The risks here are minimal, but because there are risks, this option is on the second rung.
Rung No. 3
If we climb to the middle of the ladder and fall, what are our chances of getting hurt?
Well, we are higher now, which means there’s more risks involved. We then discuss the risks you’ll find at the middle of the ladder, which involves IV or intramuscular drugs.
The narcotic analgesic we use is called Stadol, or others in this class of medications. This medication takes the edge off of the pain, but it’s not meant to numb you like an epidural. This medication does get to baby in small amounts, so it may not be given too close to your delivery.
It’s a re-dosable medication with a duration of a few hours. The benefit of this option, then, is that if mom is feeling OK, she can still move around and change positions. This medication is meant to take the edge off of the pain, not take it away.
Rung No. 4
If a mom chooses to climb to the top of the ladder—the fourth rung—the risks here are the greatest. This would be the epidural.
Having an epidural requires mom to be in bed because she is numb in the lower abdomen, back and perineum, and she usually has a catheter because she can’t get up and use the bathroom.
A study in the Journal Obstetrics & Gynecology found that epidurals can lengthen the second stage of labor by two to three hours.