Medications Used During Birth

Now that you are pregnant, your excitement is probably growing as you anticipate welcoming your new little baby into the world. But despite this excitement, you may be a little (or even a lot) nervous about getting through labor first. Deciding whether or not to use medications during labor and delivery can be particularly nerve wracking for many moms-to-be. But you can lower your anxiety levels considerably just by becoming familiar with the types of medications that you may be offered during childbirth. Here is some detailed information about the various types of labor medications, their side effects, and the pros and cons of using them.

Epidural
The epidural is by far the most common type of medication given to women during birth. An epidural is actually a mixture of anesthetic medications (like lidocaine or chloroprocaine) and narcotics (like Demerol or morphine). An epidural is administered through a catheter. This catheter is inserted in your back into the space surrounding the outside membrane of your spine. It helps to relieve labor pains by blocking most of the pain that you experience in your lower body. The epidural takes about 20 minutes to start working, but it allows for continuous pain relief while you are giving birth.

Pros:

  • The epidural blocks most child birth pains
  • It works for extended periods of time
  • You can easily control the amount of medication that runs through the epidural catheter
  • An epidural leaves you awake and alert for labor

Cons:

  • It is an awkward procedure and takes time to begin working
  • An epidural makes it necessary to have continuous fetal monitoring
  • You may lose your ability to stand or get out of bed for the rest of your labor
  • Epidurals can interfere with your ability to push, extending your labor
  • Occasionally, epidurals can cause your blood pressure to drop, decreasing baby's heart rate
  • Very rarely, epidurals can cause severe headaches (if spinal fluid leaks during insertion of the catheter)

Spinal Block
Like the epidural, the spinal block is a mixture of anesthetic medications and narcotics. It is administered during the active stages of labor or just prior to a cesarean section. The spinal block works immediately to relieve pain as the medication is injected directly into the fluid in your spinal column. A spinal block provides total pain relief from the chest down for up to two hours.

Pros:

  • Spinal blocks allow for complete pain relief
  • A spinal block allows you to remain awake and alert throughout labor

Cons:

  • The spinal block procedure can be uncomfortable to have administered
  • A spinal block can cause loss of bladder control, necessitating a catheter
  • Spinal blocks can cause a decrease in your blood pressure, which may lower baby's heart rate
  • A spinal block may interfere with your ability to push
  • Side effects can include itching, tingling, nausea, and lightheadedness

Systemic Medications
During labor you may also be offered various narcotics and tranquilizers to help you deal with any pain and anxiety that you may be experiencing. Narcotics help to dull your labor pains, but they won't eliminate them completely. Tranquilizers won't be helpful for your pain, but they can help to reduce your anxiety, allowing you to rest during labor. These medications are usually given intravenously or through intramuscular injection. They usually last between four and eight hours.

Pros:

  • These medications can reduce pain and relieve anxiety effectively
  • They may allow you to catch up on rest during the early stages of labor
  • Tranquilizers and narcotics can be administered easily, without the help of an anesthesiologist
  • They are less likely to slow labor

Cons:

  • Systemic medications can pass through the placenta and enter baby's bloodstream, making him less active upon delivery
  • These medications may affect baby's health, including his heart rate and ability to breathe
  • Side effects can be unpleasant and include dizziness, drowsiness, nausea, and itching
  • Narcotics are less effective on pain than the epidural or the spinal block
  • These medications may reduce your memory of labor and delivery

Pudendal Block
A pudendal block uses anesthetic medications to numb the area between the vagina and the anus. You may be offered a pudendal block if you have had an episiotomy or if a tear has occurred during labor. A pudendal block can also help reduce the pain associated with a vacuum-assisted delivery or a forceps delivery. A pudendal block lasts anywhere from several minutes to an hour.

Pros:

  • A pudendal block provides excellent local pain relief
  • The pudendal block rarely causes any side effects for mom or baby

Cons:

  • A pudendal block doesn't relieve labor contractions
  • This medication can sometimes decrease your urge to push
  • Rarely, a pudendal block can cause your blood pressure to drop, which may interfere with your baby's heart rate
  • There is a possibility of an allergic reaction with a pudendal block

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