All the physician anesthesiologists at AAMGI are here to provide expert care during your delivery. We know this time can be filled with a lot of questions & uncertainties especially when it comes to your anesthesia options.
You will be provided 24 hour care from an anesthesiologist dedicated to the obstetrical floor. Pain relief options during labor include opioid pain medication that is given through your IV and regional anesthesia that is performed by an anesthesiologist. We will first review your medical history and take the time to answer any questions you may have prior to the procedure.
Every woman experiences pain differently, especially during childbirth. There are many factors that contribute to the amount of pain you will feel during labor. The size and position of the baby, as well as the strength of the contractions will all factor in to your experience. In some cases, women find relief in relaxing and breathing techniques learned in classes prior to childbirth. Other women may opt to use these techniques along with pain medications.
Analgesics and anesthetics are the two types of pain-relieving drugs used for women during childbirth. There are many types of analgesics and anesthesia, and each are used for the different needs of each individual woman. Your AAMGI anesthesiologist will help you determine which type of pain relief is right for you.
Local Anesthesia
Local anesthesia provides loss of sensation in small area. It does not lessen the pain from contractions. Sometimes, your obstetrician will perform a procedure called an episiotomy prior to or during labor. Local anesthesia is often used during an episiotomy, or when vaginal tears occur during childbirth. Local anesthesia rarely affects the baby, and there are generally no side effects after the numbing wears off.
Regional Analgesia
Regional analgesia is generally the most effective pain reliever, with the fewest side effects. Epidural analgesia, spinal blocks, and combined spinal-epidural blocks are the three types of regional analgesia used to minimize labor pain.
Epidural Analgesia: Epidural analgesia, or epidural block, causes loss of sensation in the lower region of your body, yet leaves you fully conscious and alert. It can be given right after contractions start, or later in your labor. Sometimes, an epidural analgesia is used in combination with other anesthesia during a cesarean delivery.
An epidural block should make you more comfortable, though you may still be aware of your contractions and feel your doctor’s exams as labor progresses. There is a small risk of medication being injected into one of the veins surrounding the epidural space, and if this occurs you may feel dizziness, rapid heartbeat, numbness or a funny taste in the mouth. Tell your doctor right away if this occurs. Regional anesthesia for labor is a continuous epidural which is placed by an anesthesiologist in your lower back. An epidural is simply a small & soft catheter that is placed between the bones in your lower back to help ease the pain you feel during contractions through the use of local anesthesia. Once the epidural is placed, a pump will continuously run a safe amount of local anesthetic during your entire labor process to ensure you have pain relief during delivery. After an epidural is placed you will still be able to move your legs and will be able to participate in pushing during delivery. If for any reason you need to have a cesarean section during your labor process we can infuse stronger local anesthesia into the epidural to make you ready for surgery. For those patients with a scheduled cesarean section, we provide spinal anesthesia to prepare you for surgery. With a spinal anesthetic, you will be numb from your chest down and will be awake for the birth of your baby.
Spinal Block
A spinal block is also injected in the lower back. It uses a much smaller dose of the drug than an epidural block, and is injected into the sac of spinal fluid below the level of the spinal cord. Pain relief is immediate in the lower half of the body, but the effects only last an hour or two.
A spinal block is used only once during labor, often when the baby needs help out of the birth canal with forceps or by vacuum extraction. Like an epidural block it can be used with stronger anesthesia for a cesarean delivery, and has the same side effects as an epidural block. Again, if these occur, tell you doctor right away.
Combined Spinal-Epidural Block: A combined spinal-epidural block is just what it sounds like. It combines both methods of pain relief, thereby giving you the fast relief of a spinal block, along with the extended pain relief through delivery of an epidural block.
Systemic Analgesics
Systemic analgesics are given as injections into a muscle or vein. They lessen pain, while you remain conscious, and act on the whole nervous system rather than one specific area. Systemic analgesics are not given right before childbirth, as they may slow the baby’s reflexes and breathing at birth.
General Anesthesia
General anesthetics are medications that cause you to lose consciousness and go to sleep immediately after injection. You will feel no pain and not remember the experience when you wake up. General anesthesia is usually used when an emergency cesarean delivery is needed and there is insufficient time to allow for a spinal anesthetic.
A major risk of general anesthesia is caused when a woman has food or liquids in her stomach. During labor, undigested food stays in the stomach. While unconscious, this food may come back up and go into the lungs, causing damage. Therefore, you may be asked to not eat or drink once labor has started. You will need an antacid to reduce stomach acid, and a breathing tube will be inserted after you are asleep.
Depending on what is best for the health of you and your baby you may be given spinal, epidural, or general anesthesia for a cesarean delivery.
