| 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.
|
MoonDragon's Pregnancy Information: Writing A Birth Plan
