There is no question that giving birth to a child involves some amount of pain. The amount of pain a woman experiences while giving birth varies from person to person, and may be different between pregnancies. Only the woman who is giving birth can decide what amount of pain is acceptable and tolerable to her, and what methods of pain relief she wishes to use, if any.
At BGH, you will have an experienced labour and delivery room nurse with you one-on-one who will help you to be as comfortable as possible. Your nurse will have experience in guiding women in using non-pharmacologic pain management techniques, and this is a good first place to start. Breathing techniques, visualization, and massage may be helpful. Some women like to labour in the tubs that are available in our birthing rooms. Keeping mobile, especially in the early stages of labour, is important. Some women will bring things from home that may help them such as music they want to hear, or a photo they wish to focus on.
If the pain becomes too much, we have a number of options available to you.
- Nitrous oxide ("laughing gas") - this is very safe to use for short periods of time such as while in labour. It is inhaled during contractions. Nitrous oxide does cross the placenta and therefore the baby will also receive this medication while in labour. It is cleared very rapidly from the baby's system as soon as the baby is born and starts to breathe. This medication will not eliminate the pain from contractions completely, but for some women may take the edge off enough to make them tolerable. Some women feel nausea while using nitrous oxide.
- Morphine - this can be given through an IV while you are in labour. This medication does cross the placenta. It is cleared fairly quickly from both mom and baby's system. However, if the baby is born too soon after a dose of morphine is given, there is a possibility that the baby may show signs of being affected by the medication; in particular, the drive to breathe may not be as strong. If this occurs, the effects of morphine can be reversed by giving the baby a dose of Narcan. This medication will not take away your pain entirely, but can help.
- Fentanyl - this is an opioid medication similar to morphine that can be taken through the IV while you are in labour. This medication also crosses the placenta. It is cleared more quickly from both mom and baby's system than morphine is, and therefore is preferable to use this rather than morphine if it is judged that your baby will be born soon. Like morphine, it is possible for the baby to show signs of being affected by the medication after birth. If this occurs, the effects can be reversed with Narcan. This medication will not take away your pain entirely, but will help.
- Epidurals - anesthesia is on call 24 hours a day, 7 days a week and can provide you with an epidural if you want one. A small tube is placed into the epidural space around the spine and medications can be infused that relieve pain. If an epidural is working perfectly it can take away contraction pains entirely. For some women, however, it does not function perfectly, and you may have a certain spot or even side that doesn't freeze as well. The epidural doesn't take away pressure sensations and for some women those sensations are also very uncomfortable. The medications involved with an epidural can cross the placenta, but are not given into the bloodstream, and therefore we see less of an effect on the baby.