Dulling the Pain of Labor: Your Guide to Epidurals and Other Pain Killers

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"I've been told that birthing is unlike any other pain that a human can experience," says Katherine Barnwell of Clinton Township, Michigan, when asked whether she's nervous about birth of her first child. While Barnwell likes the idea of delivering her baby naturally, she's considering her options before her September due date. Like many women, Barnwell's waiting until her third trimester before discussing medications with her OB-GYN. However, doctors and midwives suggest that you talk about pain management with your provider in early pregnancy.

Knowing what kind of medications are available helps you voice your desires to your OB-GYN or midwife and feel more in control when it comes to a very vulnerable time—the delivery of your baby.

The Pain You'll Feel

Every woman experiences labor and childbirth pains differently depending on factors such as the baby's position and weight, and the length of the delivery. In general, there is a shared experience of a progression of pain working up to the birth of the baby. In the first stage, the contractions help open the cervix until it has almost dilated completely. During this stage there may be pain in the abdomen, back, upper legs, or sides.

In the next stage, when the cervix is fully dilated, the baby begins to descend from the uterus into the vagina. "This creates an increasing pressure in the rectum and lower vagina," explains Dr. Christopher Viscomi, MD, Director of Acute Pain Medicine and Co-Director of Obstetric Anesthesiology at the University of Vermont.. There is often a burning sensation as pelvic and vaginal tissues are stretched and pushed aside to make way for the baby.

Types of Pain Medications Used for Labor and Birth

Anesthesia (Epidurals)
In the US, epidurals are the most common form of medication used to alleviate pain during labor and childbirth. Epidurals work by blocking pain and two-thirds of women receive epidurals, according to Dr. William Camann, MD, and Kathryn J. Alexander, authors of Easy Labor. The medication, inserted into a woman's lower spine, works on nerves and prevents pain messages from reaching the brain. Commonly used medications administered in epidurals are Lidocaine and Nesacaine. Low doses allow women to remain mobile while higher doses take away mobility.