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Doc Talk Doc Talk: There are a variety of ways to manage labor pains

  • Published Monday, May 20, 2013, at 11:08 p.m.

Many women have fears about pain during childbirth. It is important for a woman to discuss her concerns with her obstetrician during pregnancy. There are several different options for managing and controlling pain. These options include both nonmedical interventions as well as medications. Often, a combination of pain control strategies is used.

Nonmedical ways to manage pain during labor include walking and changing position, breathing techniques, showering or bathing, using massage, applying hot or cold packs to the lower back and distractions such as listening to music. Many patients use a combination of these methods during early labor. Childbirth preparation classes, such as those offered at Wesley Medical Center, teach methods including breathing techniques.

There are many different pain medicines and ways these medicines can be administered to manage pain. Methods commonly used in our community include intravenous or intramuscular pain medicines and epidural or spinal pain medicines.

Intravenous pain medicines are strong drugs, such as narcotics, that are given through an IV. They often are used in early labor, and while they do not completely relieve all pain associated with contractions, they often can make patients comfortable enough to rest. The disadvantages of these medicines are that they can make a patient sleepy or nauseated. For this reason, they often are used in combination with antinausea medicines. IV narcotics are typically not given in late labor, as they do cross through the placenta and can make the baby sleepy at the time of delivery. Two commonly used IV narcotics in our community are Nubain and Stadol.

Epidural and spinal blocks are types of regional anesthesia, designed to block pain in a large area of the body. Administered by an anesthesiologist, these include epidural and spinal blocks. They involve placement of a small tube, or catheter, into a space in the lower back near the nerves around the spinal cord. An epidural provides better and longer-lasting pain control. The disadvantages include the inability to freely move around during labor. While some patients have specific fears about this type of pain medicine, many of those patients are reassured after speaking to the anesthesiologist prior to the epidural procedure.

This is by no means a complete list of ways to manage pain during labor. Frequently, a combination of these and other methods are used to tailor pain control to fit a particular patient’s needs. Speaking with a physician and asking questions throughout pregnancy can help prepare the patient and dispel some of the fears about pain during labor and delivery.

Doc Talk is a column about health issues by Wichita-area physicians. This column was written by Hilary Rainbolt, obstetrician and gynecologist, Heartland Women’s Group, Medical Arts Tower, 3243 E. Murdock, Suite 200; 316-962-7175.

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