Pain management during labor — The Bump
April 2017 Moms

Pain management during labor

Hey everyone- I know there is already a birth plan thread, but I thought one for pain management specifically may be helpful!

I took my birthing class on Sunday and had not even thought of the idea of narcotics instead of (or before) an epidural. What is everyone thinking? Or from STMs, how do you feel about Narcotics VS. Epidurals?

According to the instructor of the birthing class, she said narcotics these days don't really affect the infant too much. Yes, it is passed through the placenta, but she said she doesn't notice a difference between epidural babies, VS narcotic babies. I also have lumbar scoliosis, so that is something to consider as well. My midwife wants me to go get a consult from the anesthesiologist before we even know if I can have one. 

From what I have learned some pros of narcotics are; You can walk around and move if you want to, which can speed up labor. More control during pushing, you can still tell whats going on, as they don't actually numb you, you can hop into the tub if you want to, no catheter.

Epidural: you dont feel anything, it does not pass through the placenta, wont affect your mind, it is probably easier to get rest during contractions.

What are some other pros and cons?

I think our "plan" will be, A.) Natural, breathing and relaxation techniques ETC. B.) Narcotics C.) Epidural

Re: Pain management during labor

  • My plan looks similar to yours, but interested to hear what others have to say about pros/cons. My labor and delivery class is this weekend so I was planning to ask about these options! 
  • This is a great idea. I'm still uncertain what I want too, as regards narcotics versus epidural. My first thought is going natural as long as I can and then an epidural toward the end (but I know it's easy to pass by the deadline to get an epidural if you're not careful!) because I'd like to be able to move around, use the tub, etc. So that's why I think the narcotic route might be good. But there's also the fact that I don't want her to be drowsy when trying to bf, which I was told is possible depending on how soon/often before the birth the narcotics are administered. So I don't know and I'd love to hear from the STMs too. I think I've decided I won't do totally drug free this time but maybe next time, personally. 
    Pregnancy TickerMarried 7/28/12
    Angel 6/7/16
    Rainbow (DD) 4/9/17
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  • I don't have personal experience with pain management but I was talking labour with a friend this morning and she had an epidural with her first and tried fentanyl with the second. She said with the way her contractions felt with the second there's no way she would have be able to sit still long enough to get the epidural (and I agree with my first there's no possible way an epidural would have been an option, I couldn't possibly have say in one position the whole time
    they put it in) and she said with the fentanyl for her second it worked but only lasted about 5 minutes before it wore off and the pain was as bad if not worse than before she got it
  • I don't know if narcotics (for delivery) are available at my hospital. I know they don't have laughing gas. I'm just going to go with the old fashioned epidural. 
    DD #1: April 2017
    DD #2: May 2020
    Baby #3: EDD May 2023; MC October 2022

  • My hospital offers nitrous oxide, so that is definitely my first step. From there I think I would go to epidural if I wanted one. The nurse at our birthing class did say that sometimes once you are ready to push (numbers wise), they will let the baby descend more on its own without pushing if you don't feel the urge because of the epidural.  Therefore hopefully cutting down on some of that time.  In my head it sounds nice to get through some of labor, have an epidural, hopefully get to rest a.bit, and then push. Of course, that all depends on how labor is going, if I "top up" the epidural, or if we let it trickle out on its own until I get the urge to push. 
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  • I would like to avoid an epidural if at all possible. I have been meditating and trying to relax a lot. Both my mom and my sister had med free births and I would like to do the same. 

    I am on the fence about narcotics for the reasons previously mentioned. My midwife said that the hospital policy is that you can't have more than three doses in an hour and that you can't have any during the pushing stage. She said it only lasts any where between 10-15 minutes.

    The hospital doesn't offer nitrous oxicide. Which I'm super bummed about since it was my first choice. When I asked my midwife why, she said it was because of push back from the anthestiologists.
  • I was told narcs last 2.5 hours, so definitely some questions to ask at my next appt!
  • I can't remember what I had, but I did request something before I got my epidural with DS since I had to wait for the doc to do them for others before me. I feel like it did slow things down a bit, but it helped me cope with the pain while I waited. I did last longer before getting any meds than I thought I would tho, so I'm happy with the way that part of that delivery went down. 

    Since odds are now that I will be induced and I hear contractions from the pit are more painful, I'm getting that epi at the first chance I get, lol. 
    Me: 37, DH: 35 :: TCC since 2/11 SA: Perfect! CD3  HSG = Blocked Right Tube
    April- Femara 2.5mg + Trigger + IUI = BFN   May- Femara 5mg = CX - No Response on Left = BFN
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    September- Femara 5mg = CX - No Response on Left = BFN  October- 100mg Clomid + Trigger + TI = BFN
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    FET #2 Cancelled, Right Tube Developed a Hydro  8/28 Hydro & Scar Tissue Removed  Cleared for FET
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    2015- 2 failed FET. We are done
    SURPRISE! BFP 8/8/16   EDD 4/1/17

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  • We are expecting baby number 5 April 24th. This go round, if we use anything at all it will be narcotics, it allows you to relax between contractions which is really helpful and still allows you to move as you wish. 
  • 4 babies so far and 4 epidurals, but I've only had a 50% success rate. My labors are pretty fast and furious and I get over my head w the pain pretty early on so for the last 2 I literally came into triage asking for the bloodwork and iv fluids that I knew I had to have done before the anesthesiologist could do his magic. I don't know if this has something to do with the fact that they don't always work for me, but I've always been able to move my legs and feel contractions so I'm pretty sure I'll be requesting one again in a few weeks, although I would give the nitrous oxide a try if it was offered. 
  • I was induced with DD.. on a holiday with no available anesthesiologist in house.. they pushed narcotics and I will never go that route again. I was soooo out of it I felt drunk. I'm glad it wore off long before I had DD.. they had to call in an anesthesiologist because I needed an emergency csection but I would 100% go the epidural over narcotics if I had the choice again.
    Abbygirl 5/2012
    Baby Boy due 04/07/17
  • I'm with @mrsstuessy I hate narcotics. I've always just slugged through pain to avoid taking them. We have nitrous oxide at our hospital so that's my plan because I'm going the med-free route. I tend to have a pretty high pain tolerance, I'm hoping that applies to contractions! 
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  • @smallanimal I know it's different for everyone but I went to the hospital because my water broke, I wasn't in active labor and was only 2cm dilated so they had to induce me. I didn't think the contractions were too bad and was able to make it to 7cm before getting an epidural. And even then I didn't feel I really needed it the doctor kind of scared me into it saying we don't need any heros it will get a lot worse. Again, I know it's different for everyone and it's good to go in with a plan but ultimately I think you just need to listen to what you think your body needs in the moment. I know I ended up regretting the epidural because it didn't even work properly and it dropped my blood pressure so low that I had to lay completely flat while pushing which kind of sucked in my opinion. 
  • I had an epidural with DS, and the anesthesiologist was amazing! Even my OB asked "Did Dana do the epi? I always request Dana for my patients." The only reason I finally requested one at 7 cm, was because I had been laboring for almost 24 hours, and hadn't slept in 2.5 days. I just needed rest. With my particular epi, I was able to still feel my contractions at the top of my uterus, however it was just pressure, they didn't hurt. It wore off within two hours of delivering DS. My only issue was figuring out how to push. My pushes were not very effective, because I couldn't feel, and it took 1.5 hours of pushing. 
    This time around I am practicing the Hypnobabies technique. I'm really hoping for a med-free birth using breathing and relaxation. Narcotics make me extremely nauseous, so I would pass on those no matter what. 
  • I had an epi with DS (I think I was about 7cm and they had just broken my water) when I got it. I may have already posted this on here, but it only half worked. I could feel everything on one side of my body and if I switched the side that I was laying on the side that I could feel switched. I feel like it managed the pain a little for me without being over the top strong. I was able to walk around and take a quick shower about an hour after giving birth. 

    I plan on getting another this time around and just plan on asking them to keep the dosage relatively low so that I can still feel my legs, and feel most of what's going on when it's time to push. I have never had narcotics, but I feel like I will be more with it with a low dose epi versus narcotics.
  • I had an epidural with DS, and the anesthesiologist was amazing! Even my OB asked "Did Dana do the epi? I always request Dana for my patients." The only reason I finally requested one at 7 cm, was because I had been laboring for almost 24 hours, and hadn't slept in 2.5 days. I just needed rest. With my particular epi, I was able to still feel my contractions at the top of my uterus, however it was just pressure, they didn't hurt. It wore off within two hours of delivering DS. My only issue was figuring out how to push. My pushes were not very effective, because I couldn't feel, and it took 1.5 hours of pushing. 
    This time around I am practicing the Hypnobabies technique. I'm really hoping for a med-free birth using breathing and relaxation. Narcotics make me extremely nauseous, so I would pass on those no matter what. 

    Hypnobabies is AWESOME. This helped me to have a med free birth with DD2.

    With DD1 I got an epidural in transition b/c I freaked out and didn't realize I was in transition and felt like I couldn't do it anymore (totally normal, by the way. I know this in hindsight). Anyway by the time I got the epidural I was completely dilated 10 min later so I totally could have done without. The epi really made it hard for me to push effectively. And I had to lay on my left side b/c it was messing with my baby's heart rate so I was stuck in a very uncomfortable position and had to push flat on my back which resulted in a LOT of second degree tearing (think Frankenstein). Needless to say, never again.

    DD1 born 5/24/10.

    Missed M/C at 14 wks Feb 2012.

    DD2 born 5/14/13.

    Missed M/C at 9 wks July 2015.

    Expecting someone new 4/17/17.
  • @smallanimal I can't speak for being induced as I never was. But, my epidural was a godsend. You will be amazed at how still you can sit if you know there is a light at the end of the tunnel that the pain will go away. DH says I was like two different people in labor. Without the epi, I was grouchy (well duh, I'm in pain!) but as soon as the epi was placed, I turned into this calm, cool, collected person. I was chit chatting with all the nurses and cracking jokes. The epidural worked well enough to numb me, but I still felt the pressure of contractions and pushing, etc. It just took away the pain. After delivering baby and afterbirth, and being stitched back up (that took awhile because I had a resident (student) OB being overseen my a legitimate OB) I was able to get up and go to the bathroom and walk around if wanted.
    Me: 29 DH: 33
    Married: 5/30/2013
    DSS #1: 5/25/2007
    DSS #2: 1/22/2011
    DS #3: 7/8/2012
    BFP: 3/14/2016 ~ MC: 3/19/2016
    DS #4: 4/21/17
  • In our Lamaze class our instructor talked about receiving a very low dose of Stadol (apparently this is the narcotic our hospital uses) during her labor and that it helped "take the edge off" her contractions during transition, which certainly sounds nice :)  However I also know that I don't do well on narcotics typically, especially when I haven't had much to eat. 

    I think that my plan remains to go med-free as long as I can so that I can move around, use the tub, eat something light, etc.  I've put in my birth plan that I will request drugs (either Stadol or an epidural) if I want one and that I don't want to be offered one.  I had no idea @chelle087 that epidurals can come in low doses (although it does make sense!), and if I do get one, I'd like to request that so that I can feel what's going on and hopefully push effectively. 

    I still go back and forth on this because as a FTM who's never been hospitalized, never broken a bone except for my nose, never had major surgery, etc. I have a hard time conceptualizing what the pain will feel like, and I honestly don't know much about my pain tolerance.  So I have a plan but I'm also trying to be open to what may or may not arise as things happen. 
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  • Dax28Dax28 member
    I'm planning on being flexible. If I'm induced I'm definitely using an epi. Our labor instructor said pitosin contactions are much worse than regular ones. If I go into labor naturally I will try to avoid the epi.
  • I had an epidural with DS induced pitocin 19 hour labor but it wore off during transition and I spent the next 3 hours pushing feeling everything but too unstable to move. The anaesthesiologist refused to redo the epidural at that point. This time around I'm working on preparing med free coping methods, which I wished I did have to help manage pain and fear. Everything was great until the epidural wore off, and I felt like I went from 0-100 in minutes. I don't regret the epidural for DS since I got rest before the marathon pushing session and narrowly avoided a vacuum assist. I don't believe in a set plan but having multiple tools in case what you want doesn't work out.
    DS1 - 8-10-2015 LO2 - EDD 4-30-2017
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  • I have never had narcotics for anything so, I will not be "trying them out" during labor. I am interested in the nitrous and will be asking my OB about it. I know our hospital offers it. The negative effects would be much shorter with the gas if I didn't like it. I will be going med free as long as possible. Last time, I did feel pressured by both my husband and the nurses for the epi. 

    My epi experience wasn't terrible. I had contractions all through it and it was uncomfortable but, the placement of the needle itself is not something you will/should feel. I would also say the nurses did not manage me well though because I think I felt much more than I should have during pushing. My labor felt great with the epi. My husband and I just watched TV until they said I was ready to push. 
  • @schef070911 I am not positive, but have heard of people saying that the nurse or doctor had turned their epidural down when it came close to time to push so that they had more control. I guess I should double check with my doctor before I go
    in requesting a low dosage if it doesn't exist!
  • I am starting to have more questions that I probably need to talk to my provider about, but I'll throw them out there in case anyone has any thoughts. I know there is no real way to accurately estimate baby's size at this point, but that makes it hard because I would probably have a different pain management plan for a 6 lb baby than I would a 10 lb baby. All babies in my family have been over 9 lbs so I'm assuming ours will be as well, so I guess I'll have to make my plan erring on the side of a big baby. My concern with a big baby is tearing... my sister in law had a 4th degree tear with her 9lb 11oz baby. I know this isn't super common, but I would worry about choosing to not get an epidural and then having something similar happen. I also know episiotomies are not super common these days, but what happens if you don't have an epidural and they decide you need one? Any thoughts? 
  • @BabyBlake042017 this was discussed at my childbirth class yesterday. At least at my hospital, if you don't have an epidural and they need to do an episiotomy, they inject a local anasthetic to numb the area. It seems that my hospital doesn't do them very often though. 
    BabyFruit Ticker
  • @BabyBlake042017 there's no surefire way to prevent tearing, but there are a few things you can do to try prevent it.  Different positions for birthing as well as waiting until you feel the urge to push (rather than being told based on an internal exam), and a few other things can help. I think sometimes even just having some information on your side and techniques to try could help quite a bit because it's certainly a real fear that could cause you to tense up in labor - and then increase your chances of tearing!
    Me: 31
    DH: 36
    Married 5 years
    DD born 8/30/13
    #2 expected 4/25/17
  • I had 30+ stitches after my med-free first delivery, and they gave me a local.
    IVF/ICSI #1 - BFP, DS born Jan 2013
    IVF/ICSI #2 - BFP, DD born Feb 2015
    IVF FET - BFP, due April 2017

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