Pain management

Welia Health encourages you to meet with your provider to discuss how to have a positive birth experience while managing your pain during your birthing experience, whether it be with medication or by utilizing a more holistic approach.

Holistic pain management

  • Labor balls – Utilizing a large ‘yoga’ ball that helps the pelvis open to allow room for the baby while influencing fetal descent and dilation
  • Labor coach or doula – A person of your choosing to help with words of encouragement, a calming presence during intense moments, ice chips and or massage techniques
  • Labor bar – A device that attaches to the birthing bed allows you to be in a squatting position and can be used as leverage with pushing and bearing down
  • Other options
    • Hypnosis
    • Yoga
    • Meditation
    • Walking
    • Massage
    • Position changes
    • Baths or showers
    • Distraction techniques
    • Aromatherapy
    • Focal points
    • Visualization

Medications

Pain can also be controlled with medication and can be administered independently or in conjunction with one another, allowing you to deliver your baby with minimal pain and anxiety yet leaving you free to fully participate in the experience.

  • IV pain medications – Nubain and morphine can be administered at >4cm but less than <8cm so as to not affect the baby. These will reduce the pain but not eliminate the pain entirely.
  • Spinal – A spinal is like an epidural, but because the drugs are administered with a needle into the spinal canal, the effects are felt much more quickly. You may feel numb and need assistance in moving during the delivery. Spinal anesthetics are sometimes used for delivery by c-section.
  • Pudendal – A pudendal block numbs your vaginal area in preparation for delivery.

Epidurals and intrathecals

  • Epidural – An epidural is a method (think of a small catheter, about the size of a fishing line for delivering pain relief drugs or local anesthetics through a catheter placed in the small of the back, just outside the spinal canal. Epidurals allow women to participate in the birth experience (continue to feel touch and pressure) while relieving most, if not all, of the pains of labor. In most cases, the nurse anesthetist will start the epidural when cervical dilation is four to five centimeters.
  • Intrathecal – An intrathecal is a one-time shot of medicine. It is administered in the same areas as the epidural, but a catheter is not inserted. It is fast acting and only works for a limited amount of time, typically 1.5-3 hours.

What are the benefits?

  • Reduced discomfort of labor
  • No sedation for the soon-to-be mom or infant
  • Allows for time to rest before pushing
  • Can help reduce anxiety associated with childbirth
  • Can be used for C-section if needed

What are the risks?

  • Drop in blood pressure
  • Mild itching can occur
  • Urinary retention
  • In rare occurrences, an infection at the injection site and headache may occur

When is it “too late” to get an epidural or intrathecal?

After you are complete and ready to push, there is normally not enough time to provide the procedure. However, that may not always be true. We will assist you whenever you and your provider agree is the best time for an epidural or intrathecal.

Can I walk around with the epidural?

Not normally. Your legs will get a “heavy” feeling, and for safety reasons, laboring moms should stay in their beds after they receive their epidural.

Will I feel anything after the procedure?

Yes. Most women can still feel when they are having contractions, but they are no longer as painful, making it an advantage when it comes time to “push.”  The medication used for LABOR epidurals is not intended to totally disconnect you from the labor process.

Does the procedure hurt, and how long does it take?

The procedure is done using local anesthesia (like when you go to the dentist), which takes approximately 5-15 minutes. Sometimes placement can be more difficult and take a bit longer. During the procedure, you may feel a little “pinch” when we numb up the insertion site on your back, but you shouldn’t feel any severe pain or discomfort, and we will stop if anything we are doing hurts.

Can I be paralyzed from an epidural/intrathecal?

It is extremely rare to be paralyzed from a lumbar epidural/intrathecal. There are rare reports of nerve injury from the procedure. In those isolated cases, nerve function generally returned over time.

Will it hurt to take out an epidural?

Taking the tape off will be the most uncomfortable part of taking out the epidural. You will not be uncomfortable with the removal of the catheter itself. Remember the site may be tender for a day or two after delivery.