What is labor pain?

You can choose from a few types of pain relief for childbirth. These types include:

• Medical. Your doctor or midwife may offer different types of pain medicine while you are in labor.
• Nonmedical. This can include things like breathing techniques and massage.

You also can use more than one of these choices.

Think about what you want during labor. Your personal needs are important when you make this choice. The right choice is the one that feels right to you. Every labor is different. You may go into labor planning to use nonmedical options only and later find that you need pain medicine. For example, you will be given medicines if you need a cesarean (C-section). Plan for what you want. But be aware that things can change during labor.

Here are some medicines that you may be able to choose for pain control during childbirth.

• Spinal and epidural pain relief. A doctor injects medicine into a space around the spinal cord. This is called an epidural. A spinal is an injection of medicine into the spinal fluid. It works faster than an epidural. In some cases, a doctor combines a spinal with an epidural.
• I.V. medicines. These are medicines given through a vein. They don't stop pain completely.
• Nitrous oxide. You can give yourself nitrous oxide through a mask when you need pain relief.
• Pudendal block. You get a shot of medicine to numb the area around the vaginal opening.

You have many choices to relieve pain during childbirth. These include medical and nonmedical options. You may use more than one of these choices.

Nonmedical

Nonmedical options may help reduce pain and help you feel a sense of control during labor. These techniques include:

• Support. Having a support person with you through childbirth may help you manage your pain better. This person could be your partner, a loved one, or a friend. Or you may use an experienced birth assistant, like a doula, whose only job is to give you constant support.
• Distraction. During early labor, you can walk, play cards, watch TV, take a shower, or listen to music to help take your mind off your contractions.
• Massage. Massage of the shoulders and lower back during contractions may help ease your pain.
• Changing positions during labor. Walking, kneeling, or sitting on a big rubber ball (birth ball) are good options. The position that feels best may change as you move through labor.
• Focused breathing techniques. Breathing in a rhythm can distract you from pain and relax your muscles and your mind. Childbirth education classes can teach you different methods of focused breathing.
• Imagery. This involves using your imagination to decrease your pain. For instance, you could imagine your contractions as waves rolling over you. Picture a peaceful place, such as a beach or a mountain stream, to help you relax between contractions.
• Laboring in water. Some hospitals and birthing centers offer tubs or whirlpools for labor. Soaking in warm water may help ease the stress of labor.

Other techniques that don't use medicine to control pain include hypnosis and acupuncture.

Medical

Your options for pain relief with medicine may include:

• I.V. medicines. Examples include fentanyl and hydroxyzine. These medicines are used to help reduce anxiety and partially relieve pain. But they aren't usually used when you are close to delivery, because they can affect a newborn's breathing.
• Spinal and epidural pain relief. This is a shot (spinal) or an ongoing supply (epidural) of pain medicine near the spinal cord. It partially or fully numbs the belly and lower body.
• Pudendal block. This is a shot of pain medicine to numb the vagina and perineum. It can help relieve pain from the second (pushing) stage of labor. It works quickly and usually doesn't affect the baby.
• Nitrous oxide. You can give yourself nitrous oxide through a mouthpiece or mask when you need pain relief during labor. You can decide when to use it.