4 Medication Options for Managing Pain During Labor

September 11, 2023

pregnant woman having contraction

The pain medications available during labor and delivery have changed how some expecting mothers approach their birth plans. In fact, today, most mothers choose some kind of medication-based pain management. If you’re considering medication for pain management during labor, it’s important to know what options are available and the pros and cons of each.

“Knowing how different pain medications work and when they can be beneficial can help you effectively prepare during labor,” says Cristy Monroe, RN, a labor and delivery nurse and perinatal education coordinator at Memorial Hospital West Family Birthplace.

Monroe describes four of the most common pain medication options used during labor and delivery.

1. No Pain Medication

Using medication during labor is a choice. Some mothers choose not to use medication at all, which is OK!

Plenty of natural pain management options exist. However, if you decide not to receive pain medication, it’s important to be prepared for labor pain. Learn about the natural pain management options we offer at Memorial Family Birthplace if you are considering a natural birth.

2. Nitrous Oxide

The least invasive pain medication option is nitrous oxide (or laughing gas) — similar to what you might get for dental procedures. Though it doesn’t exactly “relieve” pain, it can help take the edge off. When considering pain medication for labor and delivery, nitrous oxide is a good place to start because it wears off quickly.

“Nitrous oxide also doesn’t stay in your system very long, which means it doesn’t cross to the baby,” says Monroe. “You can also walk around and move, which can help with the laboring process.”

Memorial West offers nitrous oxide for mothers in labor and delivery.

3. Intravenous (IV) Pain Medications

After nitrous oxide, you might consider pain medications delivered through an IV. These medications include Nubain and low doses of fentanyl. Though fentanyl may sound scary, low doses are perfectly appropriate for laboring mothers.

However, IV medications have an important drawback: they can enter the baby’s system. So while they can ease your pain, they may also sedate your baby. If you choose IV pain medication, your healthcare team will monitor you and your baby to make sure you are both safe. And because IV pain medications can affect the baby, doctors only prescribe them at certain times in the labor process.

“Some doctors may not order these medications if you are about to push to help avoid any respiratory distress on the baby,” says Monroe.

4. Epidural

An epidural, or spinal analgesia, is the most common medication-based pain management option for laboring mothers. It’s an anesthesia administered through a needle in your back, providing relief from your rib cage down to your feet. With a few restrictions, you can get an epidural at just about any point in the laboring process.

“You need to be able to hear commands and sit still to get an epidural. It’s important not to wait until you’re in so much pain that you can’t sit still. You could be almost 10 centimeters dilated, but as long as you can sit still during a contraction, we can do an epidural,” says Monroe. “And we’ll talk you through the whole process.”

You’ll also need to keep the “30-minute” rule in mind.

“Epidurals take time to kick in. First, you’ll need lab work to check for any infections and to make sure you can safely have an epidural. Then, once the epidural is in, it works like a dimmer, with the pain slowly subsiding over about 30 minutes,” says Monroe. “So if you come to the hospital and you’re almost ready to push, an epidural isn’t really an option.”

And while epidurals offer benefits during labor, some mothers may not be aware of what an epidural offers after childbirth.

“An epidural covers you after birth, not just while you’re laboring. It is helpful because you’re going to experience discomfort after birth. And if you have complications or need a C-section, you already have your anesthesia in place,” says Monroe.

While effective, epidurals come with limitations in addition to needing to sit still and the 30-minute rule. For example, you’ll need a catheter to drain urine because your legs will be weak, and you can’t get out of bed.

Compassionate Support Every Step of the Way

The staff at Memorial Family Birthplace is dedicated to supporting expecting mothers throughout labor and delivery. We have experience with a range of pain management options and can help you make the right choice to achieve the birth experience you want.

Want to learn more about pain management options for labor and delivery? Check out the birthing classes we offer.