---
title: "Epidurals and Labor Medications at Sutter Health"
description: "Learn about available pain relievers for labor, including regional anesthesia, local blocks, cesarean section medications, labor augmentation/induction and postpartum medications."
url: "https://www.sutterhealth.org/health/epidurals-and-labor-medications"
---
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3. Epidurals and Labor Medications
# Epidurals and Labor Medications
Learn about your choices for pain relief during labor.
* * *
September 26, 2025Medically reviewed by [Carrie C. Yiakis, M.D.](https://www.sutterhealth.org/find-provider/dr-carrie-c-yiakis-1046233432)
## Types of Labor Medications
[Labor](https://www.sutterhealth.org/services/labor-and-delivery) can be intense, and pain relief options like epidurals or other medications may help you cope. Knowing your choices can make you feel more prepared and confident. Your OB or nurse midwife and anesthesiologist will discuss your options for pain relief and offer suggestions based on your needs.
**Pain Relievers**
All local anesthetic-type drugs, such as Novacaine used by dentists.
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| Narcotic:
Morphine
Fentanyl
Nubain
Stadol | Early/active labor by IV or intramuscular injection. Fentanyl may also be given in spinal/epidural. | Not considered harmful to the mother/baby when given at the proper time and dosage.
Takes the "edge" off of the pain. | Makes some mothers sleepy
May experience nausea (rare)
Mother may feel less in control
Sometimes a temporary decrease in strength and frequency of contractions occurs
Depending on when given, Morphine may cause respiratory depression in the baby. If this occurs, the antidote Narcan can be administered and the side effects are immediately reversed.
Morphine may cause the baby temporary difficulty with breastfeeding. |
**Regional Anesthesia**
There are a few types of regional anesthesia your care team may use during labor. These include dilute local anesthetics, a mix of narcotics and local anesthetics, or stronger local anesthetics on their own. Your doctor or midwife and the anesthesiologist will work with you to decide which option best fits your needs, depending on your stage of labor and the level of pain relief you want.
It’s also important to talk with them about balancing pain relief with your ability to feel the urge to push and work with your contractions. Remember, the goal is to manage your pain in a way that helps you stay as comfortable and in control as possible.
All local anesthetic-type drugs, such as Novacaine used by dentists.
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| Intrathecal (Narcotic and/or local anesthetic) | Established for labor pain not relieved by other methods.
Needle inserted into central spinal fluid where medicine is injected and needle is removed. | Usually gives good pain relief.
Takes effect immediately.
Some mothers may be able to walk.
Does not alter pushing efforts. | Itching
Possible spinal headache (rare)
Limited time duration
Possible infection |
| Epidural Narcotic Only (Walking Epidural) | Established for labor pain not relieved by other methods.
Needle inserted into epidural space and small catheter placed for later use (needle pulled out after catheter is inserted.) | Usually gives good pain relief for early labor.
Some mothers may be able to walk.
Able to use catheter for local anesthetic later if needed. | Itching
Often restricts mobility
Can become spinal anesthesia if epidural catheter goes into the spinal fluid when inserted
Intravascular injection
Blood pressure can drop within the first 30 minutes after epidural is started, so frequent monitoring of blood pressure during that time
Possible risk of infection
May necessitate vacuum or forceps delivery due to decreased pushing ability
May experience spinal headache postoperatively (rare) |
| Local Anesthetic Epidural | As labor progresses, active/transition labor.
Usually given as a continuous infusion via a control pump. | Medication easily administered as labor advances.
Can shorten labor by allowing the mother to relax.
Mother can usually push with assistance; may feel pressure.
Medication can be turned down or off during the second stage if necessary to assist with pushing sensation.
Provides enough pain relief without sedation for Cesarean delivery; allows mother to remain awake during surgery. | Often restricts mobility requiring bedrest during labor
Can become spinal anesthesia if epidural catheter goes into the spinal fluid when inserted
Intravascular injection
Blood pressure may drop during the first 30 minutes after epidural is started, so frequent monitoring of blood pressure during that time
Possible risk of infection
May necessitate vacuum or forceps delivery due to decreased pushing efforts |
| Spinal Block | May be given for Cesarean birth.
Medication is injected into the spinal canal | Effective immediately. | May experience spinal headache postoperatively (rare)
Itching |
**Local Blocks**
All local anesthetic-type drugs, such as Novacaine used by dentists.
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| Local | Medication is injected into the perineum/skin immediately before or after the delivery. | Local numbness for performing episiotomy and suturing episiotomy or laceration. | Allergic reaction (rare)
Short acting |
**Cesarean Section Medications**
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| General Anesthesia | Given for an emergency Cesarean, unless functioning epidural is in place. | Complete pain relief until awake.
Rapid acting. | Baby receives the medication. May be sleepy and possibly have some transient respiratory depression.
Mother unconscious
Rare complication such as cardiac or respiratory depression or aspiration of vomitus could occur.
May cause nausea postoperatively
Requires narcotic pain medication after surgery. For example, Morphine by injection or Patient Control Analgesia (PCA) pump. |
| Epidural | May be used for Cesarean birth. Larger does of local anesthetic used to numb entire abdomen and legs through epidural catheter. | Complete pain relief.
Mother stays awake.
Narcotic may be given into epidural space for post-operative pain control. | May feel pressure during procedure
Rare complication of injection into central spinal fluid or epidural vein
Possible increase in mother's and/or infant's temperature |
| Spinal | May be used for Cesarean birth. Needle inserted into central spinal fluid and local anesthetic with/without narcotic injected. | Complete and immediate pain relief.
Mother stays awake.
Good post-operative pain control if narcotic given. | May feel pressure during procedure as with epidural
Rare complication of cardiac or respiratory depression |
**Labor Augmentation/Induction**
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| Prostaglandin Gel or insert (Cervidil) | Administered vaginally prior to induction of labor | Increases cervical elasticity and softens/ripens cervix. | Requires fetal monitoring for one to two hours after insertion
Risk for sustained contractions |
| Misoprostyl (Cytotec) | Administered orally or vaginally prior to induction of labor. | Assists in cervical ripening.
May stimulate contractions and enhance effects of Pitocin if used. | Risk for sustained contractions
Requires fetal monitoring |
| C. Oxytocin (Pitocin) | Used for induction of labor or augmentation during labor.
Administered through intravenous pump. | Induces (begins) labor contractions.
Augments (increases) strength and frequency of ongoing labor contractions. | Requires fetal monitoring
May increase frequency, strength and pain of contractions. |
**Postpartum Medications**
| Type | When/How Given | Advantages | Possible Side Effects/Disadvantages |
| --- | --- | --- | --- |
| Oxytocin (Pitocin) | Given after delivery of the placenta usually in IV bag or injection if no IV present. | Injection or one IV bag usually given after delivery to ensure that the uterus remains contracted and may prevent excessive bleeding.
Causes the uterus to contract. | Cramping |
| Methergine | Given after delivery either orally or by injection. Often a series of six pills. | Given when excessive vaginal bleeding occurs.
Stronger than Oxytocin. | Cramping and nausea
Contraindicated if high blood pressure problematic |
| Carboprost Tromethamine | Given for excess bleeding that is not stopped by Pitocin and/or Methergine | Rapid Acting
Stronger than oxytocin | Nausea and vomiting
Use cautiously if have asthma, hypertension diabetes, or renal disease |
| Misoprostol | Given rectally for excess bleeding | Rapid acting and less side effects than Carboprost Tromethamine | |
## Guidelines
Your [childbirth](https://www.sutterhealth.org/services/pregnancy-and-childbirth) experience isn’t defined by whether or not you use pain medication. All medications can affect labor and your baby in some way, but with careful monitoring, serious side effects are rare.
**Reasons for Pain Medication in Labor**
- Medical concerns, such as high blood pressure or stalled progress
- Extreme discomfort from your baby’s position, the intensity of contractions or the length of labor
- Fatigue from a long or difficult labor
**Deciding to Use Medication**
Your OB, nurse midwife and anesthesiologist will talk through your options for pain relief and suggest what may work best for you. They can also offer non-medication options if you’d prefer to try those first.
**Your Labor Partner's Role**
- Know the mother’s feelings about medications before labor starts
- Offer support and encouragement no matter what she decides
**Ways to Minimize the Need for Medication**
- Set realistic expectations. Labor is like running a marathon — hard work with a big reward.
- Take contractions one at a time and trust your body’s strength
- Ask how far along you are before making decisions — it may help to know whether you’re six or nine centimeters dilated
- Avoid making medication decisions during a contraction, when you and your baby are most vulnerable
- Accept coaching and support from your care team
- Rest or nap whenever possible late in pregnancy to save energy
**Questions to Ask Before a Procedure or Medication**
To make an informed decision, you may want to ask your doctor or midwife:
- What’s the purpose?
- What are the benefits and risks?
- Could any risks require other interventions?
- What other options can we try?
- What could happen if we wait an hour or two?
Every labor is different, and so is every decision about pain relief. What matters most is that you feel supported, informed and cared for throughout the process. Lean on your care team and know that whatever choices you make, the goal is a safe and positive birth experience for you and your baby.
## Explore related topics
[Labor and delivery](https://www.sutterhealth.org/health/articles?facets=%5B%7B%22i%22%3A%22c_healthTopics.name%22%2C%22v%22%3A%5B%22Labor+and+delivery%22%5D%7D%2C%7B%22i%22%3A%22builtin.entityType%22%2C%22v%22%3A%5B%22Sutter+Health+Page%22%5D%7D%5D&limit=10&verticalKey=health-and-wellness)
## Support at Every Step
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## Meet our care team
[Carrie C. Yiakis, M.D.](https://www.sutterhealth.org/find-provider/dr-carrie-c-yiakis-1046233432)
Obstetrics and Gynecology
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