Making the best choice for yourself for pain management in labor is something a lot of women consider before heading to the hospital. Today I’m going to lay out your four basic options and the pro’s con’s to consider of each.
This episode is inspired by my page on pain management in labor. I know it’s something a lot of women have questions on, and I have a lot of resources about pain mangement (but all the best stuff is in here).
This episode is sponsored by The Online Prenatal Class for Couples. Remember it has a WHOLE chapter on pain management, and a bonus video on natural pain management in the course.
Pain Management in Labor
Mentioned in this pain management episode
IV pain management in labor
Nitrous Oxide in Labor
Other pain management info you might find useful:
- How to say no in labor podcast episode
Producer: Drew Erickson
Check out my other pregnancy podcasts:
Check out all my podcasts:
Hilary Erickson 0:00
Welcome back to The Pulling Curls Podcast! Today on episode 56, we’re talking about pain again! That is a pain in the- No, I’m gonna keep it real clean this time although I do have a post on how the F bomb can be almost like an epidural, but let’s untangle it.
Welcome to the pulling curls podcast. I’m Hilary, your curly headed host on the podcast where we untangle everything from pregnancy, parenting and home routines. I want you to know that there are no right answers for every family and I find that simplifying my priorities is almost always the answer. It’s tangled just like my hair.
Okay, before we jump into pain, that sounds bad, but before we do, I wanted to remind you guys to subscribe A lot of you listen to this on my blog and You might have Apple podcasts on your device and not even know it and you can subscribe there and then you see every new episode and everything turns into unicorns and rainbows.
Okay, it doesn’t but it could, you never know. This episode of The pulling curls podcast is sponsored by the online prenatal class. for couples. It simplifies understanding labor so you can have a more relaxed pregnancy and birth taught by a highly experienced labor and delivery nurse that can be done wherever you are whenever you want. No more arranging busy schedules to fit in a prenatal class, say 15% with the coupon code untangled. You can find out more at pullingcurls.com in the menu under courses or in this episode’s show notes.
Okay, pain management in labor. I think a lot of people automatically think of the epidural but I actually worked at a hospital when I first started where we didn’t do that many epidurals, just the cultural makeup of our hospital and the people within it. I would maybe 50% maybe even less just not a lot of people got epidurals and so I am very used to laboring naturally with And helping them in other methods. So let’s talk about some of the methods.
We’re first of course, going to talk about the epidural. I have done a whole episode on epidural. So I just want to, you know, Cliff note it right here for you. It makes you about 80% numb from about your brow line to your knees again, 80% don’t plan on being completely pain free, it’s important that you still experience a little bit of pain. And we talked about that in that episode.
So I’m just gonna let you guys all click on over to that one. It’s in the show notes. It does have more risks to it because they’re puncturing your skin, they are close to your spinal column. There are not a whole lot of risks and we do lots and lots of epidurals, I have very rarely seen a problem, the most frequent problem is a spinal headache from them going too far and then having to back up, that does not mean that you can be paralyzed with an epidural, I think you probably could be but that’s not a spinal headache is not getting close to being paralyzed.
It’s just different. It is also more painful to have put in so a lot of people are afraid of needles and all that kind of stuff. And that totally makes sense. So the epidural might be out for some of you, but I think it’s also really good In the research all of these, so I’m excited that we’re going to talk about the other ones. Okay, the next one that people can choose is IV pain medication. Now this is the one that we use most often in my hospital.
When I first started, there are two medicines that we mostly use fentanyl and stayed off. Now those are ones that we will use in labor, we do not use morphine and labor because it lasts a long time. I’m honestly not exactly sure why but we don’t use it in labor. So federal and state all it really just depends on your doctor and how far along you are.
There are some pluses and minuses to both of those, you guys really don’t need to know that because your doctor will just order us to get one at that time. Whatever time we’re giving it, it is given an IV which means you have to have an IV. Hopefully that makes sense to everybody and you cannot get it too close to delivery. The reason for that is that some of those medications can stay in your system and make baby tired when they come out. And we need baby alert and screaming and all those kind of things.
So we don’t want a baby that just wants to nap when they come out. However, there are medications that we can give you to reverse the pain medication if for some reason we give you medication and you’re forced into And then all of a sudden you hit complete and you have your baby in five minutes we could give the baby something to counteract that.
So we just don’t want to it’s not nice for the baby or Yeah, that’s why we try not to give it close to delivery and if it’s your second baby or on eight nine centimeters, you might not be able to get IV pain medication and usually right when people are like, Okay, I need something for is right when they’re about to have their baby. I’m just gonna put that out there. Okay, some people also get IV medicine to like get them to the epidural and I think that’s your choice.
Some doctors won’t let people get the epidural until they’re three centimeters or something like that. But honestly, if you’re just planning on getting an epidural, I would wait as long as humanly possible. I do believe it is better to wait past three centimeters if at all possible, but sometimes it’s not just get the epidural. I wouldn’t let IV medicine like get you to the epidural personally but your doctor may not order an epidural until later on and so that might be your best option.
Okay, one that is not available right now. I am speaking during the COVID I need a better word for COVID nightmare, the COVID conundrum is nitrous oxide. Now the reason we’re not giving it is it is blown air it blows into your airway and COVID then circulates and aerosolized into the room which makes it more potent to your partner and to ourselves.
So we are not doing nitrous oxide right now full disclosure, we have nitric oxide machines at our hospital but we haven’t been trained to use them and we haven’t started using them because right as they were going to ramp that up COVID started and yeah, so they are sitting there. nitrous oxides is just like what you would get in the dentist’s office. It just takes the edge off of the pain. One of the beauties of nitric oxide is it is out of your system very quickly, and mom 100% controls it.
So mom puts it on her face, she falls asleep, it falls off mom wakes up. We definitely don’t want your partner controlling it and shoving it on your face because then you could fall asleep and he’s pushing it on your face and then you know we don’t want that. So mom 100% controls it. No one else gets to touch it. It takes the edge off. If you guys have seen called the midwife. They bring something similar around with them and people love it on that show, so I’m excited to get to use it.
I think it could be that thing that when you’re wanting something to take the edge off, you know you’re eight nine centimeters and we can’t give you IV pain medication, it can be the thing that carries you through it. So I’m excited to get to use it. I would love to hear in the comments of the show notes if anybody used it and how they loved it. I do have friends in Canada that have used it who really liked it.
So there you go, there are some contra indications the M th fr gene can make it problematic. So it is something that I would talk with your doctor ahead of time to see if one your hospital offers it and to if it’s okay for you. Okay, the other thing that people can use is natural pain management. And I don’t want you guys to think that that is not a just as viable of an option as IV or nitrus. It is not going to numb you like an epidural. I don’t think we should ever pretend like you’re gonna have a pain free labor by using natural pain management techniques, but it can definitely get you there and a lot of people really love it feel really empowered by it.
I have boiled those into two sub categories personally, there is the Bradley method where you kind of concentrate on focus items. or something like that, but I haven’t had patients who’ve had a whole lot of luck with that. There’s the Lamaze breathing type thing. And I do teach that in the online prenatal class for couples. I have a whole video if you get the course on how to do breathing, and all that kind of stuff, and I think it is super helpful. I think it’s important to have some breathing techniques in general because raising kids makes you want to breathe.
Every once in a while I have done my Lamaze breathing with my teenagers a lot. So I think it’s a great technique to learn either way. And even if you’re planning on getting an epidural, you should still learn some of these techniques to get you to the hospital and to just help you relax before you get to the hospital because I’m a big believer in trying to labor as much at home as you can before you get to the hospital.
So I think natural pain management techniques can totally do that. Now the other one is hypno babies where you kind of go into a hypnotic state. I’ve had a lot of friends had luck with this. I do not teach it because I think you need a separate class that is just on that. I do recommend hypno babies I will put all the information down below.
I do have a discount code, all that jazz, but that’s something that you need to prepare in advance. Like I- if you’re heading into 20 weeks, I would definitely look at it at that if you’re thinking 35 weeks I don’t think hypnobabies is a viable option for you because it really takes a lot of time for you to prepare listening to those tracks ahead of time and really getting into it. I think it’s a great option. I personally can’t focus on anything like they do and have no baby so I don’t know if it would work for me.
Full disclosure, I did get epidurals with every single baby. Some of them worked better than others of them. But I have a labor nurse first though, you know, we just get things kind of weird. I always wanted to go natural, but I got induced on my last baby. And it is really hard to go natural with an induction and I didn’t know how long I was going to be pregnant. I was already 12 days overdue. I had not slept in a long time so I wasn’t in a great place to start with. So I just don’t want you guys to feel like the epidural is your only option. There are tons of other options.
So talk with your doctor. Take a prenatal class I go through all of these very thoroughly in the online prenatal class. for couples. We have a whole chapter on pain where I talk about epidurals, but also the other options as well. So get educated. Because I think you need to prepare in advance, I have a post on my site about how stress affects your baby at delivery. And I have to say that I’ve had women who are just complete basket cases, and I don’t mind. But the problem is their baby comes out.
And they are so stressed out because their mom is just, you know, it’s almost like she feels like she’s on fire, you know, and all of those fight or flight hormones that are coursing through her body, get to the baby, and they get out and they’re just like, I’m done. I’ve run a marathon with this woman already. And I don’t want to cry, I just want to hang out. So I don’t like my mom’s like that. I definitely try and use techniques with them to help them to calm down.
But if you really are at a place where you cannot calm down, you’ll probably want to switch to a pharmacological method to help you calm now, that’s just my personal opinion. I just think it’s really important that you prepare in advance for pain management options. Okay. I did ask in my groups for a few questions that you guys had about pain management. So somebody asked what is the last time you can change your mind and get your epidural now It really depends on how many centimeters you are How many babies you have.
So on your first baby, you can honestly just get an epidural whenever the heck you want. If you’re 10 centimeters, and your baby’s still a little bit high, I’ll give you an epidural. Sure, because you still got two hours on average of pushing ahead of you so we can get you an epidural, the baby can come down, and then we can push the baby out, and you’ll be a little bit more comfortable.
Now if it’s your second baby, you probably you know, your 10 centimeters, you probably only have 15 to 30 on average, it would depend on it, how if we checked you now if your baby’s still really high, then that would change things. But second baby usually at nine centimeters, I would say girl, let’s just do this. Let’s just do this because with an epidural, you’ve got to think you’ve got about an hour have we given you an IV fluid bolus plus the doctor putting it in plus it’s starting to set up you know, are you going to have that time in order for it to work and it does need time in order to set up and if your baby’s going to be out in that timeframe, then you know, it would be better to avoid the rest of the epidural then get it put in.
So… But if it’s your first baby, just get an epidural you can just kind of get out whenever obviously once you start pushing, then they’re not gonna put an epidural in at that point and and honestly It feels real good to start pushing. So if you know you’re nine centimeters and you’re in a lot of pain, the good news is when you hit 10 centimeters and you start pushing people love how that feels.
Because I don’t know if you guys have ever been to the point where you really need to poop this very similar feeling, it’s just a relief to be able to start pushing against it. So welcome for a little TMI from the pregnancy nurse. Okay, how effective are IV meds? What are the risks versus an epidural IV meds, take the edge off. And so a lot of people the one thing about IV meds is a lot of people don’t like how they make them feel because you feel out of it or a lot of people compare it to like being drunk.
So I just tell people don’t fight it. Just relax into it and try and go to sleep. Most people find that the contractions are a little bit shorter and further apart because they’re just not feeling it as much and they can relax which is really important because your cervix is like part of your body and if you tense up your whole body with every contraction, it’s not going to open and your baby’s never going to come out.
But if you’re able to relax with IV medication or some sort of pain management technique via lumos, or an epidural, that will really help your Maybe come down. So there you go, I think they can be really effective. However, IV medication is only effective 123 times first time works like a charm. Second time works pretty good.
Third time you’re wondering if I just gave you say ln, because it’s just not as effective, your body’s become tolerant to it. And so that’s something to keep in mind when I have women who are like two centimeters saying, Oh, I’m only going to use IV pain medication. Let’s start now I have a nice talk with them about how maybe they’re gonna want to consider some other options because the pain medicine usually lasts an hour, sometimes two hours if the pain isn’t too bad, but usually an hour if you’re in hard labor pain.
So if you’re two centimeters, you got to think you’ve got about eight hours of labor ahead of you, you know, to do the math yet when the pain gets really bad, you’re not going to have the IV medication just isn’t gonna work as well. Again, take my class guys, I go into all of this like a lot. This is just a speech boat over the lake of pain management in labor. So I love to dive deep into pain management.
Okay, looks like that’s it. Somebody had a question a little bit more on nitrus but I pretty much told you everything I know about nitrus I’m excited to use it. Not a lot of hospitals have it though. So definitely, if that’s your plan, call your hospital in advance and see if they’re using it. And FYI, I don’t know any during the covid conundrum that are using it right now. That is pain management and labor.
I would love to see you guys in my full class. I’ve said that enough. But if you guys have any questions about the class, though, I’d love to answer them. You can always ask me at my blog pulling girls calm. Otherwise, definitely check out the show notes where I’ll have links to more information on epidurals IV pain medication, all that kind of stuff. I actually have a free beginning prenatal class where I talk about third trimester concerns and test your doctor my order so you can jump in there too.
Thanks so much for joining us today. I hope we help smooth out a few of the snarls in your life. We drop an episode every Monday and we always appreciate it when you guys share and review. Until next time, we hope you have a tangle free day!
Transcribed by https://otter.ai