Childbirth classes will help you cope with the pain of labor and birth by teaching relaxation methods, breathing techniques, and an awareness of what will be happening to your body. You may also choose to have a professional labor support person or doula present. Doulas are specially trained in the art of labor support and the many techniques available to help enhance, speed up, and reduce the pain associated with birth. Many women also choose to use medications to help manage the pain. Investigate the benefits and risks of medication. Discuss these benefits and risks with your careprovider, childbirth educator and of course, your partner. All that you learn in childbirth class and in reading, plus the tools will help to raise your pain tolerance. Pain tolerance is simply the ability to tolerate a certain level of pain. A woman's pain threshold is the point at which a woman can no longer tolerate the pain. You can increase pain tolerance and raise the pain threshold by using nonpharmacologic (natural) and pharmacologic (medication) measures.

Local Anesthesia: An injection that numbs a small area. You may be given a local anesthetic if you need an episiotomy to avoid a tear in the perineum (the area between the vagina and rectum). Local anesthesia rarely affects the baby.

General Anesthesia: Causes total loss of consciousness and is sometimes used for Cesarean births.

Epidural Block: An injection into the back (in the epidural space, just outside of the membrane that holds the spinal cord) that causes some loss of feeling in the lower half of the body. An epidural block may lessen pain from contractions, as well as pain in the vagina when the baby emerges. Epidurals are one of the most common forms of pain relief. Some side effects may include numb, heavy legs, as well as a drop in the mother's blood pressure which could slow the baby's heartbeat. Some mothers have had their labors slow down or stop with epidural anesthesia. This may make other interventions such as pitocin (used to enhance or speed up labor), forceps, or vacuum extraction necessary. Additionally, having an epidural started before 4 centimeters dilation seems to increase the risk of having a cesarean section - the muscles in the lower body cannot work with the movements of the baby and often babies have a difficult time getting into position. This, in combination with slow or stopped contractions, may indicate cesarean section.

Spinal Block: An injection into the lower back. With a spinal block, you may have to stay in bed since sitting up too quickly may cause spinal fluid to leak out of your lower spine, giving you a bad headache. Pain relief may only last one to two hours, and the mother's blood pressure may drop, which could slow the baby's heartbeat.

Additional choices of pharmacologic pain management varies with geographic location. It is best to check with your care provider and childbirth educator to see what your choices are.

References:

1. Bobak, I., Jensen, M. Maternity & Gynecologic Care: The Nurse and the Family. (1989) St. Louis: Mosby Publishers.
2. Nichols, F., Humenick, S. Childbirth Education: Practice, Research & Theory (2000) Saunders & Co.
3. Whitely, N. A Manual of Clinical Obstetrics (1985) Philadelphia: J.B. Lippincott Company.
4. Reeder, S., Martin, L., and Koniak-Griffin, D. Maternity Nursing: Family, Newborn, and Women's Health Care. (1997) Philadelphia: J.B. Lippincott Company.