Possible Effects of Medication and Anesthesia

Options for labor without pain medication

There are many options available to help you through labor without using pain medications and epidurals, and with no detriment to your labor or your baby. In fact, these methods will optimize labor progress, infant health, and breastfeeding success. 

• Take a childbirth class with your partner so you can learn and practice breathing, relaxation, and other techniques to help in labor. Have a coach to help and encourage you. Practice together before labor.
• Have a helper who is experienced with childbirth. This may be a friend, family member, or a doula.
• Have a doula. A doula is a person trained and experienced in helping women through labor; she’ll give you support and guidance. Having a doula has been shown to shorten labor, decrease complications, and increase breastfeeding success. Ask your nurse if doulas are available in your area.
• Stay at home in early labor, as long as possible.
• Attitude is important: see labor not as something that happens to you, rather it is the work you do to deliver your baby!
• Play music and have a calm, dim environment. This may help you relax.
• What you think about during labor can really help you through it. Here are some things to think about: each contraction brings you closer to your baby; labor is a normal, healthy process; your body is well-designed for this wonderful process; you a part of bringing a new person into the world!
• Stay out of bed and upright. Walk, stand and shower. Use gravity to help bring your baby down!
• Ask to have the fetal monitor as much as possible. This allows more movement, and decreases unnecessary interventions.
• If monitoring is needed, ask to have telemetry monitoring. If available, this will allow you more mobility.
• Walk. This keeps you upright plus stimulates your contractions. It also keeps you off your tailbone, and so opens more space for your baby to come out.
• Use a birthing ball to sit on or lean over. This helps relieve back pressure, helps you stay upright, allows your helpers to massage your back, and helps your pelvis open for the baby.
• Use the rocking chair.
• Use the shower. Use of water in labor reduces pain. If you have back discomfort, point the shower spray over your back. If you want to sit while in the shower, you may use the ball or shower chair.
• Use the birthing tub, if an option. The motion and warmth of the water lessens pain and also helps your tissues stretch so there’s less tearing. It makes a comfortable transition for the baby and can speed labor.
• Sit on the toilet: not only for emptying bladder and bowel, this position helps your pelvis open! 
  Talk with your provider if you desire other ways to help you through labor.
• There may be situations when Pitocin and/or pain medication may be helpful in achieving a vaginal delivery. Talk with your provider about these situations. 

Detrimental Effects

Pain medications and anesthesia in labor have been shown to have detrimental effects on labor progress, your infant, and breastfeeding. These detrimental effects include: 

• Prolonged labor.
  Am J Obstet Gynecol 2002;186:S31-77 and 2014 Mar;123(3):527-35
• Prolonged pushing stage.
  Obstet Gynecol 2014 Mar 123(3):527-35
• Your blood pressure may drop, giving your baby less blood flow; this lowers his oxygen levels, and could lead to fetal distress.
  JAOA 106(12)Dec 2006
• You may have difficulty urinating.
  AmJObstetGyn2002(186)
• Decreased infant alertness, ability, and readiness to feed.
  Midwifery Today 2007
• Your baby may have trouble breathing.
  Arch Dis Child Fetal Neo Ed 2014 Mar 99(2)
• Disorganized infant suck.
  J Hum Lact 2003(14), 438-439
• Depressed infant reflexes including sucking. 
  Birth 2001
• Delayed milk onset. 
  J Hum Lact 2014 May;30(2):167-73
• Decreased milk volumes. 
  Int J Obstet Anesth 2004 Jan 13(1):25-9
• Shortened duration of breastfeeding. 
  Anesthes 2005;103(6)
• Increased infant weight loss. 
  Pediatrics 2003;1112:607-619
• Higher cesarean section rate. 
  AmJObstetGyn 2002;186:S31-68
• More likely to need forceps or vacuum extraction. 
  Cochrane Database Syst Rev 2011 Dec 7
• More likely to need Pitocin augmentation of labor. 
  Am J Obstet Gynecol 2002; 186:S81-93
• Greater incidence of fever in labor, which may lead to antibiotics. 
  Int Anesthesia Research Society 2010; 111(6) 1467-1475 
• Greater incidence of your baby being born with a fever, getting blood tests, IVs and antibiotics. 
  ACOG 2002 (100)1
• More severe perineal lacerations. 
  Int J Gynaecol Obstet 2014 Apr; 125(1)6-14
• Higher rates of postpartum hemorrhage and neonatal jaundice. 
  South Med J 2005; 98(4)419-422 Am J Obstet Gyn 2002 May;186(5):S31-68

Research behind labor without medication

Research shows that laboring without medical interventions, anesthesia, and drugs can accomplish: 

• Faster, easier births.
  Brit J of Anesth, 2004;93(4):505-11
• Healthier, more active and alert mothers and newborns.
  Cochrane 2004(2):CD000111
• Mother and baby are more ready to breastfeed. 
  Cochrane Rev 2000; Birth 28:1, 2001