Vaginal birth

• Most women give birth through the vagina (birth canal).
• Labor occurs in three stages and feels unique to everyone.
• If you’re healthy, wait for labor to begin on its own.

When it comes to managing labor pain, some expecting moms prefer to deal with the pain of childbirth naturally, using breathing and relaxation techniques. Others decide from the start to use pain medication to help manage labor pain. One option for pain medication during labor is a spinal block (also called a spinal).

How it works

• A spinal can be given during active labor or just before a c-section.
• The woman is given an injection into her lower back, which numbs the lower body.
• The medication blocks pain in the lower half of a woman's body while she is awake and alert.

How it's given

• The spinal uses a much thinner needle to inject medication than the needle used for an epidural.
• While you are sitting or lying on your side with your back curved outward, the health provider inserts the needle for the spinal into your lower back.
• A small dose of medicine is given as a shot into the spinal fluid (fluid-filled space that surrounds the spinal nerves in your lower back).

How it affects you

• A spinal block only needs to be given once and provides pain relief from the chest down.
• The medication is usually given during active labor, so it's best for pain relief during delivery of the baby.
• Good pain relief starts right away.

Pros

• A smaller needle is used for injection into the lower back.
• Pain relief starts right away.
• You remain awake and alert.
• The medication can also be used if the health provider uses instruments to help the baby out during vaginal delivery.
• Sometimes a spinal is given along with an epidural. This provides you with immediate pain relief and the option of more medication if you need it.

Cons

• While pain relief with a spinal starts quickly, it lasts only 1-2 hours.
• It may provide uneven pain relief, affecting one side of the body more than the other.
• Your blood pressure can drop during a spinal, which may slow your baby's heartbeat. To prevent this, you'll receive extra fluids through an intravenous (IV) tube. Lying on your side can also improve blood flow.
• The medication can make it difficult for you to control or empty your bladder, so you may need a catheter (a small flexible tube placed in the body).
• In very rare instances, you may get a bad headache. If not treated, this "spinal headache" may last for days.
• You may feel some soreness from the spinal injection after delivery and it may lasts just a few days.
• If too much medication is given, it can affect your chest muscles. This may temporarily make you feel like you're having trouble breathing. However, this is rare.

Changing your mind after natural labor
Labor pain affects each woman differently. Some women may have a mild discomfort and others may experience intense pain. If you try natural childbirth and during labor you begin thinking about using pain medication or anesthesia to cope with labor pain, know that it's okay to change your mind. Don't feel like you let your baby down or gave up. Only you know how strong the pain feels. It's okay to talk with your provider and do what you think is best.

April 2010