Medication in Labor
I can guarantee that no medication will take all of the discomfort away. Some women are quite alarmed after they have received medication expecting a completely pain-free labor from that point on, only to find themselves angry and frustrated at having to cope with labor in spite of the medication. The degree of effectiveness of each type of medication will vary between individuals. Administering pain medication usually comes with extra interventions. One in particular is the IV fluids via which systemic medications are usually given and must be received before regional anesthesia is given. Medication also requires constant fetal monitoring since it may have an adverse affect on the baby.
Systemic medications are usually opiates injected directly into mother's blood stream. The most common medications used in childbirth are stadol, demerol, fentanyl, and morphine. While they may alleviate pain to some degree, they will not eliminate pain during childbirth. One important side effect of these medications to consider is they will make you sleepy or drowsy. Other side effects are nausea, vomiting, slowed breathing, itching, constipation/ urinary retention, and a possibly significant risk on initial breastfeeding efforts. These medications do cross the placenta and pose certain risks to your baby as well.
Over 85% of birthing women across the country receive epidurals. Most women mistakingly believe that this method of pain-relief is complete and risk-free. They are being told by anesthesiologists that epidurals carry minimum risk to mom and virtually no risk to baby. In reality, the risks associated with epidurals can be great. Receiving an epidural means an immediate need for other interventions. Before an epidural can be administered, an IV will be inserted and one full bag of fluids given. Once the epidural is administered, a urinary catheter is inserted because most women cannot urinate with an epidural. The catheter increases the risk of urinary tract or bladder infections, which may require antibiotics to treat, which puts mom at risk of a yeast infection and baby at risk for thrush.
Epidurals severely limit or completely restrict the positions and mobility mom has available to her during labor and pushing, usually to lying or semi-sitting, and only in bed. If administered too early in labor, the epidural may slow or stall contractions, leading to labor augmentation with Pitocin. Other risks include: lowered blood pressure, spinal headache, feeling of not being able to breathe if done too high, persistent numbness or weakness of lower extremities, nausea and vomiting, shivering, maternal fever (possibly leading to NICU workup for baby), and rarely even maternal death. Many epidural patients also report lower back pain for days, weeks, or even years following their epidural.
Epidurals pose certain risks to baby as well. Your baby may experience decreased fetal heart tones, which could culminate in a cesarean. Once your baby is born, you may be welcoming a baby who is drowsy, has a poor sucking reflex, has decreased muscle strength and tone in the first hours of life, decreased bonding, and breastfeeding difficulties.
No matter which form of medical pain relief is chosen, the medication is ideally stopped or slowed to wear off before pushing begins. This is to allow mom to feel her contractions and pushing urges to get her baby out. This means she is facing the toughest part of labor, transition, with little or no pain medication. In a previously medicated mom, this means a significant increase in discomfort since her endorphin levels have been disabled by the pain medication she received. Not only does mom's natural endorphin production cease, but so does baby's, decreasing his or her ability to cope with contractions.
I strongly recommend that any pregnant woman has at least some knowledge of natural methods of pain relief, even if she plans to have medication. You never know when one of these techniques might be a life-saver!
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