Going
into labor? Consider the options for pain management
By Suzanne Hancock
December 23, 2004 | It's
hard work getting a baby into this world. It isn't called
labor for nothing, every mother's labor experience and
degree of pain is different. Thank goodness for pain
medication.
The types of pain relief come in a wide variety. They
can be given intravenously. They can numb your whole
body or just the lower half. They can even be mixed
to suit your needs. So when it comes to making the decision
the options seem to be never ending. Each type of pain
medication has its pros and cons and it is important
to weigh them before a decision is made. What one woman
may feels is best another women may not. There is a
lot of information to know when trying to choose the
right pain medication for you.
Systemic medications are painkillers
like narcotics and sometimes tranquilizers that will
dull your pain but not completely get rid of it. It
is given through an IV directly into the blood stream.
Because they are injected through your blood stream
your entire body will be affected. Often times it will
make you sleepy.
The pros of systemic medication are that this medication
works well with women who can endure a little pain but
just need something to take the edge off. Another pro
is that it's easier and less invasive than an epidural.
The cons of systemic medication are that it in the doses
used for labor it is less effective than a regional
block (ie.epidural or a spinal). They can cause side
effects like drowsiness, dizziness, and disorientation.
Systemic medications cross the placenta and therefore
affect the baby. Sometimes the narcotics can make it
harder for a baby to begin to breathe after birth, especially
if the mother is given a large amount within a few hours
of delivery. A medication can be given to counteract
the effects if needed.
An epidural is a continuous flow of
pain relief to the lower part of the body, while allowing
a full state of awareness. It is delivered through a
catheter inserted into the epidural space, which is
just outside the membrane that surrounds the spine,
which allows the medication to be administered when
needed. The baby's heart rate will be monitored continuously,
and the mother's blood pressure will be taken about
every five minutes to make sure the medication isn't
having any bad effects.
The pros of having an epidural are that it can be used
throughout labor and delivery. The anesthesiologist
can control the effects by adjusting the type, amount,
and strength of the medication. The mother can be awake
and alert during labor and can rest during the second
stage of labor, which means that she will have more
energy when she needs to push. Only a tiny amount of
medication reaches the baby with an epidural. The cons
of having an epidural are that it reduces the likelyhood
of a mother being able to walk while the epidural is
in place. This is due to the numbing effect. The mother
and baby require more monitoring with an epidural. It
can also cause contractions to become less frequents
and intense, which can be fixed with a drug called Pitocin.
The loss of sensation can make it harder to push the
baby out. Sometimes an epidural can give spotty pain
relief. Meaning that it could only work on one side
of the body and maybe not the other. An epidural can
cause headaches and in few causes effect breathing.
It also requires more time to kick in than other pain
relief methods. There may be a higher chance of having
to use forceps.
According to Dr. Heiner, an obstetrician at Logan Regional
Hospital, an epidural can increase your labor by about
20 minutes.
"When a mother has been in labor for a long period
of time what is another 20 minutes," says Heiner.
In Cache Valley depending on the month, around 86 percent
of women who give birth at Logan Regional Hospital opt
to have an epidural, Micheale Webb, a registered nurse
in labor and delivery, said.
"It is safe and effective and has very little risk.
It doesn't cross the placenta," Webb said. "They
have become more sophisticated over the years."
A spinal block is a quick way of delivering
effective pain relief to the lower part of the body
for a short period of time. It injected through a needle
into the spinal fluid in the lower back. A spinal differs
from an epidural in two ways: It's delivered directly
into the spinal fluid and it's a one-time injections
rather than continuous feed through a catheter. As a
result, relief is rapid and complete but lasts only
a few hours.
The pros of having a spinal block are that you get quick
pain relief. Only a tiny amount crosses the placenta.
The cons of a spinal block are that they decrease sensation
and make it harder to push the baby out. The drugs may
temporarily lower blood pressure. It can cause itchiness,
particularly in the face. It can also cause nausea.
"At Logan Regional this are used more for Ceasarian
sections rather than vaginal births," said Webb.
Another option is going medication free.
"It is a mental thing. You have to mentally prepare
yourself before you come to have the baby. It also helps
if you have had Lamaze classes that teach you how to
breathe," he said.
The pros of not having any medication are that your
baby is not effected by medication. According to some
women who have gone without medication you feel like
you are in a euphoric like state after the baby is born.
The con of not having medication is that you will feel
pain.
There are many different options and many different
types of pain medications available for labor and delivery.
It is important for mothers-to-be to talk to their physicians
and discuss their options with them. Some hospitals
may not offer some types of pain relief. And some mothers
may not be able to have some type of medication. A physician
can answer any questions.
There are also plenty of Web sites that can give you
great information on different types of medications.
It is hard to decipher what Web sites to believe and
which ones not to believe. There is a Web
site that gives a run down of each website and whether
it is accurate.
NW
LD |
