Narcotic Analgesia

Narcotic medications, such as morphine and nalbuphine, can be used in labor. They are given either as a shot or intravenously. Narcotics slightly take the edge off the pain, but do not completely relieve it. They have the disadvantage of often causing drowsiness and nausea. Narcotics are most likely to be given in the active stage of labor. Most women can tolerate pain better when they are pushing because they can be active, and are less likely to need narcotics. You also want to be at your most energetic and alert during this stage so that you can push effectively. Some women use narcotics only for labor pain, while others use this type of analgesia as a way to handle pain until they request epidural analgesia (which is frequently delayed until you are more than 4cm dilated). Narcotics affect your level of alertness, and this will take a while to wear off.

Choice Of Medication

Most narcotic drugs are equally effective and have similar side effects. However, there are some that are possibly worse than others for the baby. Make sure you understand what medications you are being given during labor. One particular narcotic drug, meperidine should be avoided. In the body, this drug is converted to a substance called normeperidine, which can stay in your baby's system for days and affect his or her ability to interact with others. Safer alternatives are nalbuphine and morphine, both of which are more quickly cleared from the baby's system. However they may still make your baby drowsy and affect the baby's heart rate patterns.

Since one of the side effects of narcotics is nausea, many care providers will automatically give you a sedative drug called promethazine together with your dose of narcotic. Although experiencing nausea is unpleasant, you may want to ask your care provider not to give you promethazine unless you develop nausea, since it will make you very drowsy with out easing pain.

Spinal Block

Spinal analgesia is often used to block pain during a cesarean delivery. Similar to an epidural, it will usually numb you to pain and light touch from the top of your belly down. It is unlike epidural analgesia in that a needle is placed in to the spinal fluid (rather than outside the spinal sac) and a small amount of local anesthetic is injected in to the fluid. Leaking of spinal fluid occurs with about 1 percent of spinals and can result in a bad headache. Spinal analgesia lasts only 1-2 hours and can't usually be readministered.

Pudendal Anesthesia

If you don't have an epidural or if your epidural is not working well (a rare occurrence), your care provider may need to numb your pelvic area for a forceps delivery or to repair a tear. A pudendal block numbs sensation in the pudendal nerve, which supplies feeling to the genitals and inner thigh. To place a pudendal block, your care provider will place his or her fingers inside your vagina to help guide the injection. A small amount of local anesthetic is injected beneath the vaginal wall.

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