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It is always best for the baby and many times for the mother if she chooses to give birth drug free and naturally using relaxation, meditative, and comfort techniques for labor and delivery. Keep in mind, whatever is given to the mother has some effect on the baby. However, under certain circumstances, pain relief may be necessary. Become an informed healthcare consumer before agreeing to the use of any medication or procedure.
A variety of drugs can be used during childbirth. To best understand their impact on you and your baby, it is your responsibility to talk with your caregiver about the types, dosages, and effects of medication you may be given. The following is general summary.
Medication Class Advantages Disadvantages SEDATIVES
Early to Active Labor
- Promotes rest if uterine contractions are irregular.
- No Pain Relief.
- Limits mobility of woman during phase of drug activity.
- Depressing to infant if given close to birth.
TRANQUILIZERS
Early To Active Labor
- Promotes Relaxation.
- Enhances effect of analgesia.
- Treats nausea.
- Drowsiness.
- Dry Mouth.
- Some agents may concentrate in infant and depress activity.
ANALGESICS
Active Labor,
Cesarean Birth,
Postpartum
- Pain Relief.
- Permits woman to surrender to labor.
- Allows woman to rest between contractions.
- Limits woman's mobility during active phase of drug.
- May decrease strength and frequency of contractions.
- May decrease maternal respiration.
- May depress infant if given close to birth.
LOCAL
Second stage of labor
- Local Pain relief without systematic effects.
- Administration may be uncomfortable.
- Effective only in area that anesthetic is administered.
PUDENDAL BLOCK
(agent injected bilaterally through the vaginal wall)
Second stage of labor.
Forceps use.
- Provides pain relief throughout perineum.
- No impact on pushing efforts.
- Useful for episiotomy & repair.
- Administration may be uncomfortable.
EPIDURAL
Active Labor
Cesarean birth
- Very good pain relief.
- Provide pain relief without sedation.
- Allows woman to be fully alert during labor/birth.
- Administration may be uncomfortable.
- Occasional incomplete pain relief.
- May decrease strength and frequency of contractions resulting in use of Pitocin (induction drug).
- May interfere with baby's rotation due to laxity of pelvic musculature (i.e. persistent posterior position).
- May lower maternal blood pressure so IV & continuous external fetal heart monitoring are required.
- Woman may also need to wear a pulse oximeter & receive O2 by mask.
- May require urinary catheterization if unable to void, which may increase risk of urinary tract infection.
- May interfere with pushing efforts during the second stage & increase the need for forceps or vacuum extraction.
- Woman confined to bed and limited in choice of positions. Prevents ambulation which is known to enhance labor.
- Impact on newborn is still an ongoing study.
SPINAL
Forceps delivery.
Cesarean birth.
- Complete relief of pain from upper abdomen to toes
- Administration may be uncomfortable.
- May lower maternal blood pressure.
- May have residual spinal headache.
- Remote chance of nerve injury.
GENERAL ANESTHESIA
Some agents administered by IV; gases administered by mask/endotracheal tube intubation.
Cesarean birth.
- Complete relief of pain.
- Quick induction of anesthesia in true emergency.
- May be woman's preference if she is anxious about regional anesthesia.
- Woman unconscious and unable to participate in birth.
- Potential cardiac & respiratory depression in woman or newborn.
Adapted from chart formulated by Christine M. Peterson, MD
MoonDragon's Pregnancy Information: Writing A Birth Plan
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