Your options during childbirth

by Kaiser Permanente |

As your due date approaches, you and your clinician will discuss the options you have for things like pain management. Knowing the choices that you have for the birthing process will help you decide what is best for you and your baby.

Pain management

Pain management is a personal decision, and there are no right or wrong choices. It is also fine if you change your mind during labor.

For most pain management options, your care team will continue to offer you choices throughout your labor. A few, such as epidural anesthesia, require you to make a decision earlier in your labor. Your clinician will work closely with you to choose the pain medications that best suit you and your situation.

The most commonly used pain medications during childbirth include:

Intravenous pain medications

These are administered directly into the bloodstream and are typically narcotic pain medications. They often relieve some, but not all, of the pain during childbirth. They often cannot be given close to delivery time as they can cause your baby to be sleepy.

Epidural anesthesia

The strongest, most consistent pain relief during labor is injected into the epidural space around the spinal column. Epidural anesthesia needs to be planned in advance. It can’t be started too close to delivery as you must be able to sit very still for it to be administered safely. It takes about 15 to 30 minutes to get the treatment started, and about 30 minutes to take effect. Using epidural anesthesia means you can’t walk or move about the room.

Nitrous oxide

Commonly called “laughing gas,” it is administered through a mask during contractions to ease the pain. It is self-administered, giving you more control over pain relief. This is not available at all hospitals.

Some pain medications can make you and the baby tired, but your care team will watch the baby carefully to ensure that it is not in distress.

Inducing labor

Most births don’t require inducing labor. Here are few reasons your clinician may suggest speeding up the birthing process:

  • You are 1 to 2 weeks past your expected due date.
  • Your water broke, but labor did not start.
  • Your labor is not progressing as expected.
  • You have diabetes.
  • You have developed high blood pressure, preeclampsia, or an infection during pregnancy.
  • Your baby needs medical treatment and the risk of vaginal delivery is low.
  • The placenta can no longer sustain the baby.
  • Your baby is showing signs of distress.

If your clinician thinks you need to have labor induced, they can help you by:

  • Sweeping your membranes with a gloved finger to separate the amniotic membrane from the uterus to stimulate your natural hormones and start labor.
  • Breaking your waters, which means rupturing the amniotic sac with a small, sterile tool.
  • Giving you IV medication that is a synthetic version of your own natural hormones to trigger labor.
  • Using a soft balloon to stretch the cervix open.

There are times when labor stops progressing. Perhaps you are tired and can’t push anymore, or the baby might be in distress. You and your clinician will discuss the best course of action to keep you and your baby safe.

Your options may include assisted childbirth, where the clinician guides the baby’s head out of the birth canal, most often with a vacuum suction cup on the baby’s head. This method is used to avoid a cesarean birth, known as a C-section.

If assisted childbirth doesn’t help or is not possible, you and your clinician will discuss if C-section is the best choice for you and your baby’s health.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.

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