OBSTETRIC TECHNOLOGY
Pain Management
One of the most important concerns for pregnant women is how their pain will be controlled during labor and delivery . Childbirth classes teach relaxation techniques , breathing methods , and other means of coping with labor pain . Some women may desire additional pain relief that can be discussed with your hospital team .
• Sedation – Pain medications may be given through your IV line or intramuscularly . These medications sedate you and lessen your pain . They are usually given at your request and in the maximum amount that is safe for you and your baby . Do not be afraid to ask for pain medications during your labor for fear of adversely affecting the baby . Many times the pain relief will help you relax , which may speed up the labor and delivery process .
• Pudendal block – The pudendal nerve provides sensation to the vagina and rectum . By injecting a local anesthetic adjacent to this nerve , your physician can relieve some of the pain in this area of your body . A pudendal block is usually placed immediately prior to delivery .
• Epidural anesthesia – An epidural block involves placement of local anesthetic into the space surrounding the spinal cord . A tiny , plastic catheter is usually inserted in this space to provide a route for administering a constant infusion of anesthetic . An epidural block usually eases the pain of contractions but cannot remove the pressure felt at the time of delivery . Fortunately , we have the assistance of an excellent team of anesthesiologists who are very skilled in the administration of epidural anesthesia . Before an epidural can be placed , you must have an IV in place and laboratory work performed . During placement of the epidural , you will be asked to sit or lie on your side with your back curved outward until the procedure is completed . It will take several minutes for the block to start working . Once the epidural is in place , you will not be capable of walking safely and therefore must stay in bed . You may need a catheter to drain your bladder , as you will no longer be able to feel when it is full .
• Spinal anesthesia – A spinal block involves an injection of local anesthetic into the spinal fluid . It provides quick relief but only works for a few hours . A spinal block is most commonly used for C-section or for operative vaginal delivery in those patients without anesthesia .
• General anesthesia – General anesthesia is sometimes used for C-sections , especially those that are performed STAT ( meaning that they need to be performed swiftly due to a medical concern ). The anesthesiologist will administer medications through your IV line . Once you are asleep , he or she will place a breathing tube in your airway to provide oxygen and as a safeguard against regurgitation of stomach contents into the airway . Because of this risk , you will be allowed only limited liquids while you are in labor . Because general anesthesia passes through the placenta into the baby , its use in obstetrics is avoided if possible .
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