Medications

Every woman copes with the pain of labour differently. Some women want to give birth without medications; others want to have as much medication as they can get, as quickly as possible!

This is a completely personal decision. You should never feel pressured to take medication you don't want. As discussed in other sections, positioning, massage and breathing techniques can and do reduce pain, but their effectiveness varies from woman to woman.

For some women, these techniques are enough; other women choose to combine them with medications to reduce the amount of drug they use. If you do choose to avoid or delay medication, it is wise to investigate the medications you might choose if you change your mind.

There are two main drug options for pain relief:

• narcotic drugs, such as morphine, given early in labour
• an epidural

Which option you use will depend on:

• your preferences
• where you are giving birth (The medications commonly offered differ in different areas of the country.)

You should talk to the anesthesiologist (a doctor trained to administer pain medication) about any health conditions or allergies you have that might limit your use of medications.

Narcotics

Drugs, such as meperidine (Demerol®) or morphine, can be given during early labour, if the birth is not expected within four hours. These drugs relieve pain, although pain relief may be less complete than the relief achieved with an epidural (see below).

These drugs can also make you feel dopey and "out of it." Because they do cross the placenta, they may slow your baby's breathing after the birth and interfere with his or her ability to suck and breastfeed. Your caregivers should avoid giving such drugs too close to the time of birth, and should be watchful for these side effects if narcotics are given late in labour. These medications are usually injected into a muscle, but they may also be given intravenously by a physician.

Epidural

An epidural uses local anesthetic (a medication that numbs the area and causes loss of feeling). This medication is injected into the lower back, to numb the nerves to the uterus and birth canal. A small dose of a morphine-like drug is often included to reduce the amount of freezing required.

An epidural does not make you or your baby sleepy and can be used without slowing labour; however, epidurals do often lead to other interventions, such as fetal heart monitoring, which can extend the time it takes to deliver. Some types of epidural will numb your legs and lower body, making walking difficult. Other types of epidurals do not cause weakness or numbing in the legs. These are commonly called “walking epidurals.” If you decide to use an epidural, talk to the anesthesiologist about what type is right for you. Click here for more information about epidurals.

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