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Labor Pain Management Options

Prepared by: Andrea Parde, MD Vickie L Wenzl MSN, APRN-CNS, RNC Shereen Young MSN, RN

Communication is Key  Good communication with your health care provider before your delivery will provide a more satisfying experience  During your labor it is important to be open to suggestions from your OB team

Variety of Pain Management Options Talk to your health care provider about what options are available for your current medical situation. You might be able to choose a combination of the following to help you during your labor:  Labor support  Labor positions  Relaxation and breathing  Massage  Water therapy  Heat and cold  Pain medications (analgesia)  Epidural (anesthesia)

Choose your Labor Support Person They help to:  Provide comfort and assurance that what you are experiencing is normal  Serve as an advocate for you  Serve as a “memory keeper� about your birth experience

Choose Positions that are Comfortable and Help with Progress of Labor Positions should:  Promote relaxation  Comfort  Enhance labor

Changing Positions and Movement is Important During Labor  Move around and walk  Gravity helps with labor  Can increase the size and shape of the pelvis  Helps rotate and move the baby through the pelvis Please note: sometimes there are medical restrictions

Relaxation and Breathing  Select a focal point your support person, special photo or memorabilia  Concentrate on your breathing  Meditation

Massage as a Coping Technique Your support person can help you relax during labor with massage

Whirlpools used to Decrease Pain

Whirlpools in Labor & Delivery Suites help with relaxation during labor and after delivery

Cold used to Decrease Pain

Ice packs can be used to help with lower back pain

Pain Medications There are a variety of different medications available to help with pain:  Anti-anxiety to help you relax  Sedatives to help you rest  Analgesics to alter your perception of pain

Epidural Pain Management Epidural is a type of anesthesia in which a local anesthetic is injected near the spinal cord and nerve roots to block sensations of pain from an entire region of the body, such as the abdomen, hips, legs or pelvis during childbirth.

MD Anesthesia Coverage Saint Elizabeth provides in-house physician placement of epidurals 24 hours a day, 7 days a week for labor and cesareans.

MD Anesthesia Providers  Our board-certified Anesthesiologists are here to help you manage the birthing process by providing a range of pain-relieving options  These physicians have received specialized training and are highly skilled in delivering top quality pain relief and anesthesia  Their role is to help ensure that you have a safe and comfortable delivery and recovery

Board-Certified Anesthesiologists Terry Clementson, MD Ronald Hill, MD Joseph Hranac, MD Ginger Massey, MD Arthur Molnar, MD Barb Molnar, MD Mike O’Donnell, MD

Andrea Parde, MD Greg Sailer, MD Erik Schneckloth, MD Matthew Shaw, MD Jeff Swanson, MD John Varvel, MD Lyle Woerth, MD

Benefits of an Epidural during Labor  Effective pain relief available for labor and birth  Provides local anesthetic for pain relief  A relatively comfortable vaginal delivery regardless of baby’s position  Minimal side effects on you or your baby  Can allow you to remain alert and awake

Common Side Effects of Epidural  Nausea/Vomiting  Lowered blood pressure  Palpitations  Dizziness/Light-headedness  Sore back for a few days

Rare Complications  Inadequate block  Long-term back pain  Headache  Infection  Nerve injury or paralysis (RARE)  Trouble breathing  Seizures

Reasons You May Not be Able to Receive an Epidural  If you are unable to position yourself with assistance  If your blood clotting is abnormal (sometimes seen in preeclampsia)  If you have an infection at needle insertion site  Previous back surgery in your spine

Preparation for Placement  Informed consent is obtained  Medical history reviewed  IV placed & fluids given  You will be positioned in a sitting position with your spine flexed toward anesthesiologist (rarely you may lay on your side)  One support person is allowed to be in the room with you

During Epidural Placement  Your skin will be disinfected  Local anesthetic will be used to numb skin at insertion site  Your anesthesiologist will place the epidural  Needle is then removed leaving only a soft flexible catheter in place  Catheter is secured with a large dressing on your back  You may still be aware of your contractions in the form of pressure

After Epidural Placement  The epidural begins working in approximately 5 - 15 minutes  Nurse will assess your level of pain  Nurse and anesthesiologist will work together to maintain your level of comfort  Your nurse will frequently monitor you and your baby’s vital signs  Your baby’s heart beat is monitored continuously

After Epidural Placement  Epidural infusion is started to keep you comfortable during labor  You will notice a change in movement and sensation  Afterwards you will remain in bed  A foley catheter may be placed into your bladder to drain your urine

Closing Thoughts Regardless of what approach to pain management you choose:  Communication is key  Be open-minded to all the techniques available to make your delivery safe and satisfying

Thank you from

The Advanced Baby Center

Labor Pain Management Options  
Labor Pain Management Options  

An overview of labor pain management options