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Pain is a natural part of labour and birth, but every woman's experience is different.  

Similarly, there are lots of different approaches to managing pain.

Many women cope with pain with the help of:

• a supportive person
• relaxation and breathing techniques
• warm baths and showers
• changing positions
• massage and/or visualization
• ice packs
• acupuncture and/or acupressure
• hypnosis

However, sometimes women in labour need additional pain relief. Here are some of the options, along with their benefits and side effects:

Nitrous Oxide and Oxygen (Entonox), Commonly known as laughing gas.

Side Effects

• Only recommended for two to three hours.
• Dizziness and temporary tingling in face or hands.
• Dulls pain, but doesn’t eliminate it.

Benefits

• Can be used right up until birth with no effect on the baby.
• The mother holds the face mask and breathes in desired amount.

Narcotic Pain Medications, such as Morphine, Fentanyl

Side Effects

• May make baby sleepy. Narcotics given near birth may affect some babies' ability to breastfeed.
• Due to effect on the baby at birth, narcotics are usually given before the transition phase of first-stage labour in order to wear off before baby is born.
• Makes some women feel drowsy, dizzy or nauseated.
• Dulls pain, but doesn't eliminate it.

Benefits

Can be provided:

• Intramuscularly (IM) - medication injected directly into a muscle.
• Intravenously (IV) - medication injected directly into a vein.
   
• Works within 20 - 30 minutes and lasts two to four hours when given IM.
• Works within two to three minutes and lasts one to two hours when given by IV.
• Time frames may vary depending on the medication.
• In general, narcotic medications make most women feel sleepy and relaxed.

Epidural/Spinal, Local Anaesthetic

Epidural/Spinal, Local Anaesthetic can be injected into the space around the spinal cord, providing pain relief from the waist down.

During a caesarean birth, pain relief is from the breastbone down.

Side Effects

• May result in bed rest while leg control is temporarily limited.
• Shivering and itching.
• Blood pressure must be checked frequently.
• An intravenous drip (IV) will likely be inserted during epidural.
• Women usually have a fetal monitor during an epidural, which may restrict movement.
• A catheter may be inserted into bladder to drain urine.
• Urge to push or push effectively may be restricted.
• Increased risk of forceps delivery.
• Pain relief may not be complete.
• Some women report headaches after an epidural.

Benefits

• Used at any time during labour to provide the most effective pain relief.
• Amount of medication can be increased if needed.
• May be used for a C-section so mother can be awake during birth.
• Women don't tend to feel drowsy or groggy.

Pudendal Block, Local anaesthetic

Injected to numb the pain around the vagina, pudendal block and local anaesthetic blocks the pain in the vagina, vulva and perineum.

Side Effects

• May affect some babies' ability to breastfeed immediately after birth.

Benefits

• May be given at the time of birth.

General Anaesthetic

During the use of general anaesthetic the mother is fully sleep during caesarean and birth.

Side Effects

• A woman may react to anaesthesia or other medications during the surgery. This can be dangerous to her health. An example of a reaction is her blood pressure dropping quickly.
• May cause throat to feel dry and sore after the anaesthetic due to the breathing tube placed in her windpipe while she was asleep.
• May cause nausea and vomiting after surgery.

Benefits

• Used when an epidural or spinal is not possible or safe.
• Used when there is not enough time for an epidural, such as in an emergency.

Resources & Links:

HealthLink BC: Labor and Delivery
HealthLink BC: Childbirth: Epidurals
HealthLink BC: Spinal Block for Childbirth
HealthLink BC: Childbirth - Opioid Pain Medicines
HealthLink BC: Childbirth - Pudendal and Paracervical Blocks