One of the most common questions pregnant patients ask about is what kind of anesthesia they will have while in labor. It is important to remember that different people have different tolerance to pain. This means that what is right for one person may not be right for you. Another thing to keep in mind is that we do not use one type of anesthesia exclusively; it will vary from patient to patient. You do not have to have any type of anesthesia if you do not want it. The only exception to this would be in an emergency situation.
Natural Childbirth or Unmedicated Childbirth
This means essentially no medication during labor and delivery. In reality only certain patients can tolerate this. Usually they have had children before and know what to expect or have been to labor preparatory classes such as Lamaze classes. If you are considering natural child birth we strongly urge you to attend these classes. Keep in mind that even if you plan no medication but find the pain of labor is too much that you can always ask for something. Should any perineal/vaginal repairs be necessary, a local anesthetic can be used.
This is where a painkiller is given through your vein. This means you have an "IV". Stadol or Nubain are the most common drugs used. Basically this will not kill the pain but will decrease your awareness of it. IV medications may make you somewhat sleepy and drowsy, especially between contractions. The small doses of these medications we use in labor do not have a significant effect on the baby. If an episiotomy is needed then either a local anesthetic or a pudendal anesthetic (which is discussed later), will be given.
An epidural blocks the nerves that transmit the pain of uterine contractions. A needle is placed through the back into the epidural space. A small plastic catheter is left in the space for the duration of labor and delivery. The epidural numbs you from your abdomen to your toes. In general the pain relief is excellent. An epidural cannot be given until you are in good labor pattern, usually at least four to five centimeters. If you are having problems with labor your doctor may wait to give it until later or he/she may choose not to give it at all. This is for your safety and the safety of the baby. Epidurals do not affect your alertness and you can still push with contractions.