Vaginal birth

• Most women give birth through the vagina (birth canal)
• Labor occurs in three stages and feels unique to everyone.
• If you need an induction, have it when you’re full term.

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You can't wait to meet your precious baby. But if you're like most first-time moms, you may be anxious about the actual birth. Just how much does labor and delivery hurt? And how will you cope with the pain?
Each woman experiences labor differently. Some women are more sensitive to pain than others. The size and position of the baby and the strength of your contractions also affect the amount of pain you experience. Some women can manage their pain by using breathing and relaxation techniques they learned in childbirth education classes. Other women find they need extra help to ease the pain.

There are many ways to make labor and delivery more comfortable, including:

• Relaxation techniques
• Breathing exercises
• Pain-relieving drugs

Learn as much as you can about your options. Find out which pain-relief choices are available at your hospital or birthing center. Discuss your preferences with your health care provider ahead of time.

It's best to remain flexible and see how your labor goes. If your labor takes an unexpected turn, you may need to change your plans. Here are some of the common approaches to pain relief during labor and delivery.

Pain-relieving drugs
A number of drugs are commonly used to help ease the discomforts of labor and delivery. They are generally safe for mother and baby. But drugs differ in how helpful they are. All pose some risks for both mother and baby, although most are not serious.

Pain-relieving drugs fall into two categories: analgesics and anesthetics.

About analgesics

• Analgesics relieve pain without the total loss of feeling or muscle movement.
• Analgesics reduce pain, but do not always stop it completely.
• Systemic analgesics are often given as injections into the muscle or vein. They are called “systemic” because they affect the whole nervous system. Systemic analgesics reduce pain, but do not cause loss of consciousness.
• Regional analgesia tends to be the most effective form of pain relief during labor. It causes few side effects. Examples are epidural blocks, spinal blocks, and combined spinal-epidural blocks. With these pain-management methods, the woman gets an injection in the lower back to numb the lower body.
• Narcotics are a type of analgesic. These powerful drugs decrease the way a person perceives pain. They make it easier for women in labor to rest.

About anesthetics

• Anesthetics block all feeling, including pain.
• Anesthetics also block muscle movement. \
• Local anesthesia creates numbness or loss of feeling in a small area. It does not reduce the pain of contractions.
• General anesthetics cause you to lose consciousness. If you are given general anesthesia, you will fall asleep and feel no pain. This option is used when other choices aren't possible or aren't the best choice for medical reasons.
• If you have a cesarean delivery, you may be given general, spinal or epidural anesthesia. The choice will depend on your health, the health of your baby, and the medical conditions surrounding your delivery.

Non-drug options
You can help make your labor more comfortable by learning all you can about drug-free methods for pain relief. Examples include acupuncture, hypnosis, relaxation techniques, and changing position frequently during labor. Some of these methods can ease discomfort early in labor. They can then be followed by pain-relieving drugs, if you need them.

Taking a childbirth education class is a good way to find out about your labor and delivery options. Many cover a range of pain-management options. Most teach breathing and relaxation techniques that can help you control pain during contractions.

Deciding what's right for you
Here are some questions to ask as you explore pain-relief methods:

• How does the method work?
• How will it affect me and my baby?
• How quickly will it work?
• How long will the pain relief last?
• Can I combine the method with other types of pain relief?
• When during labor is the method available?
• Is the method available at my hospital or birthing center?

You can ask for pain relief at any point during labor and delivery. The more you know about your options, the better able you'll be to make decisions that result in a more comfortable and satisfying delivery.

January 2007