By Brian D. Welsh, M.D.
To use or not to use any form of pain control at all during a vaginal delivery is a very personal choice. At North Texas Women’s Healthcare, we encourage patients to explore their options for pain control and choose the best option for their situation.
Overall there are three broad categories.
The first option is to use no medication for pain. Many patients today are choosing to deliver without the assistance of any anesthesia, which we encourage as a completely acceptable option.
Secondly, there is the option of IV pain medications. There are several IV options that each physician may choose from. They have been shown to provide some pain relief with delivery, although, a Cochrane review, (a large think tank that reviews all research), found that overall the relief was poor, and that rates of nausea and vomiting increased. For me personally, I also do not offer IV pain medications to individuals with advanced cervical dilation. The reasoning behind this is that this class of medications can decrease respiratory drive. Mom can easily overcome this reaction, however, if baby is born with the medication still in his/her system it can provide a confusing picture to the infants caregiver.
Finally there is an epidural. With this option, a qualified Anesthesiologist will be at the hospital who will place your epidural. Currently over 60% of all women giving birth in the United States use an epidural as their choice for pain control. It is important to be aware, that to date, there is no evidence that has ever shown an epidural leading to an increased risk of a cesarean delivery.
Nitrous oxide is an option that is used rather extensively in the UK, however, the hospitals where we deliver do not currently offer this as an option.
Your choice of pain control is exactly that, YOUR CHOICE. As your physicians, we simply desire for you to be educated on the matter, and make the choice that is best suited for you and your growing family.
We know you will have many questions about the anesthesia choices and we want you to ask your physician any questions you have regarding your pain control options. It is important that you feel informed and comfortable with your decision.
Thank you for allowing us to be a part of this special time for your family.