Delivery time: Steps to pain management

Think of your options as rungs on a ladder.
The options for pain management can grow increasingly stronger, but they also carry a greater risk. (For Spectrum Health Beat)
The options for pain management can grow increasingly stronger, but they also carry a greater risk. (For Spectrum Health Beat)

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.
  • Music.
  • Setting the room atmosphere to your comfort.
  • Relaxation techniques.
  • Massage.
  • Hydrotherapy—using the tub.
  • Aromatherapy.
  • 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.

The family birth centers at Spectrum Health Zeeland Community Hospital, Spectrum Health Ludington Hospital and Spectrum Health Gerber Memorial offer this option.

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.

Moms, it’s up to you to choose for both you and your baby. What are your plans for birth?

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Comments (3)

  • I am 10 days shy of my due date and have decided to go without any pain medication while in labor. This will be my second delivery and I chose to go the same route with my first daughter. I am so thankful that I have a husband that supported me in this, as I could not have done it without him. My recovery after delivery was so much quicker than my friends’ who have had epidurals. I remember everything clearly and did not have the medicine head that other pain medications can give. It also gives your baby the best chance of success, both improving the chance of vaginal delivery and successful nursing. I would really encourage pregnant women to make the decision to go without pain medication ahead of time and stay on step one.

  • Samantha Kauffman-I am an MSW graduate student at Grand Valley doing a qualitative research project surrounding single first time mothers who used the services of a postpartum doula. I am in need of three woman who fit this criteria who are willing to participate in an approximately one hour interview based on their experiences for our research project. All information is kept confidential and only used for our class assignment purposes. I have done work as a postpartum doula hence my interest in the topic. I came across your articles(s) that involve some information on doulas and just thought I would reach out to see if you may have some suggestions or know individuals who would be open to an interview. I would really appreciate hearing from you!

  • I had four kids, all with epidurals. I am totally for them! I was up and moving right away and had very quick recoveries after birth. If I could do it all again, I wouldn’t change it.

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