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How painful is labor and delivery? — The pain of labor and delivery is different for every person, and for every pregnancy. It depends on many factors, including the size of your baby and the way they are positioned in your uterus. The pain is usually mild early on in labor, but gets worse as you get closer to delivery.
Pain can come both from contractions (when the uterus tightens) and, later, from your vagina stretching as you push your baby out.
Should I make a plan to manage my pain? — Yes. Talk with your doctor, nurse, or midwife toward the end of pregnancy about how you can manage pain during labor and delivery. There are many ways to manage pain, and no one way works for everyone. You might want to try several ways to manage pain. The right decision is the one that is best for you.
Although it's helpful to make a plan before you go into labor, keep in mind that your plan can change. That's because your labor might be more or less painful than you expect.
What are the different ways I can manage my pain? — In general, you can manage your pain with:
●Things you can do on your own
●Medicines
What can I do on my own to manage my pain? — To help lessen your pain, you can:
●Change your body position
●Do relaxation or breathing exercises
●Take a shower or bath
●Have someone massage your lower back
●Put heat or cold on your lower back
●Listen to music
●Take a walk
●Have a "doula" help you – A doula is a person who stays with you during labor and delivery to support and reassure you.
There are lots of different methods you can use to help during labor and delivery. They might involve the things listed above, plus other things to help you relax and feel positive about giving birth. Your doctor, nurse, or midwife can talk to you about the different methods. They might also be able to suggest a class that you and your partner can take to help prepare you for labor and delivery.
What if I want medicine to manage my pain? — If you want medicine during labor, let your doctor or nurse know. Doctors can use different medicines to help manage the pain of labor and delivery. The medicines can be given in different ways.
Options for pain relief include:
●An epidural or spinal block – For an epidural block, a doctor uses a needle to put a thin tube (called a "catheter") into your back. They will give you medicine through this tube. For a spinal block, the doctor injects medicine into your back to numb the nerves in your spine. In many cases, the doctor combines these things, so you get a dose of medicine right away, and then the catheter stays in for the rest of your labor. The medicine can usually remove the pain in the lower part of your body.
●A pudendal block – For a pudendal block, a doctor uses a needle to inject medicine around the nerves near the vagina. The medicine numbs the nerves so you don't feel as much pain while pushing your baby out. Unlike an epidural, it does not help with the pain of contractions. It is sometimes done in people who can't have or don't want an epidural. It can also be done in addition to an epidural, if you still have a lot of pain in the vaginal area.
A pudendal block is also sometimes used if the doctor has to do an "assisted" delivery. This means using a tool called "forceps" or a special vacuum to help get the baby out.
●Opioid medicines – These are pain medicines that you can get through a thin tube that goes into your vein, called an "IV," or as a shot. They mainly work by making you feel sleepy, which can help you not feel as much pain.
●Nitrous oxide – In some countries, there is the option of using a gas called "nitrous oxide" to help with labor pain. The gas is inhaled through a face mask or mouthpiece. Nitrous oxide is available in some hospitals in the United States, but not all.
What are the downsides of the different medicines? — Medicines and procedures come with different downsides.
Some downsides of an epidural block include the following:
●After you get an epidural, you will probably need to stay in bed and won't be able to walk around.
●An epidural can lower your blood pressure.
●If you have an epidural for more than a few hours, you might get a fever. If this happens, the doctors might decide to give you or your baby antibiotics in case you have an infection.
●After you give birth, you might have a headache.
Some downsides of opioids include the following:
●Opioids can cause nausea or vomiting, in addition to making you feel sleepy.
●Opioids affect your baby, too. If you get them too close to delivery, they can make your baby too sleepy. Sometimes when this happens, the baby needs help with breathing after birth.
●Each dose of medicine eventually wears off, so you might need more than one dose. Because doctors need to be careful not to give opioids too close to delivery, you might not be able to get them when you are having the most pain.
●Since opioids work by making you sleepy, you might have a harder time pushing your baby out.
How can I manage pain after birth? — It is normal to have some pain after you give birth. You might have:
●"Afterpains" – These can feel like cramps as your uterus returns to its normal size. They usually go away within a week of giving birth. Pain relieving medicines like acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) can help.
●Pain around your vagina – If you had a vaginal delivery, your vagina and the area around it might be sore while you are healing. To help relieve pain you can:
•Use cold or heat – If it feels good, hold a cold or warm washcloth on the area for 10 to 20 minutes at a time.
•Take "sitz baths" – This involves soaking the area in 2 or 3 inches of warm water. Do this for about 5 minutes at a time, 4 times a day.
•Use numbing spray – Your doctor or nurse might suggest using a medicine that comes in a spray. It numbs the skin to help with pain. Witch hazel pads might also be helpful.
•Use pain relieving medicines
If your pain is severe, tell your doctor or nurse. They might want to examine you to make sure your pain is not caused by something other than normal healing. They might be able to suggest other medicines to help with pain. Some medicines are not safe to take if you are breastfeeding your baby.
Patient education: How to tell when labor starts (The Basics)
Patient education: Labor and delivery (childbirth) (The Basics)
