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Understanding Childbirth Medications

Labor Medications
Medications are available to women who experience prolonged, exhausting labor.
Medications are available to women who experience prolonged, exhausting labor.
©2006 Publications International, Ltd.

Once the childbirth process begins, the pregnant mother begins experiencing painful contractions that grow in intensity. Medications that stop the pain, however, cannot be used right away.

The Use of Pain Medications or Anesthesia

Pain medications have been used in childbirth for centuries. At one time even alcohol and opium were used.

When using pain medications, you make a tradeoff. In return for relief of pain and tension and possible speeding up of labor, you accept the possibility of side effects on labor progress, on your mental or physical well-being, or on your baby. You and your doctor must balance the advantages and disadvantages in your situation before using or not using medication.

First of all, the choice of natural versus medicated childbirth really exists only as long as the labor remains normal. If, however, you or your baby requires intervention (such as induction of labor, use of forceps, or a cesarean section) for medical reasons, you will need pain medication.

Medications for Early Labor

Because the medications that provide the greatest pain relief also tend to interfere with early labor progress, they cannot be used too early, unless you want to stop labor. Medications are available if a very prolonged and exhausting prelabor or early labor has caused excessive anxiety and worry.

Sedatives or barbiturates (sleeping pills or medications) may help you rest. These are given in pill form or by means of injection. They may temporarily halt your labor while relaxing you or allowing you to sleep. These drugs reach your baby, who cannot easily excrete them, so it is important not to receive large doses. Because babies born with such drugs still in their bodies may have problems breathing or sucking, your doctor will probably use only small doses and will try to ensure they have worn off before birth.

Tranquilizers are also used in long prelabors to reduce muscle tension and anxiety. Certain medications also help if you have severe nausea and vomiting. Depending on the drug, you may feel dizzy and confused, your mouth may feel dry, and your blood pressure could be altered. These drugs also cross the placenta to the baby and may have effects on fetal heart rate and newborn muscle tone, suckling, and attentiveness.

Morphine, a narcotic, may be used in an attempt to stop a long, nonprogressing labor. While it may cause you nausea, dizziness, and confusion, it also may do just what you need -- put you to sleep and stop labor temporarily. Narcotics tend to linger in the baby and can have some effects on the baby's behavior and breathing after birth. The greater the amount of the drug given, the greater the effects on the baby.

Medications for Established Labor

Once your labor is well established, it is less likely drugs can slow it for more than a short time. More effective pain-relieving drugs may then be used. Also called analgesics, these drugs are given by means of injection under your skin, into your muscle, or into an intravenous line.

Demerol (meperidine) is the narcotic analgesic most widely used in obstetrics. Its effects are similar to those of morphine and may be associated with a speeding up of labor in some circumstances. If anxiety, tension, and pain are great enough to actually slow labor, a narcotic or tranquilizer may reduce anxiety and allow labor to speed up again. These drugs reduce your pain, though you are still aware of the peaks of your contractions. They also help you sleep or relax between contractions.

You may feel nauseated shortly after receiving them, and you may not like the dizzy, confused feeling. The pain relief lasts for an hour or so, after which another dose may be given. The drug does accumulate in the baby's body, however, and larger total doses may have more noticeable effects on your baby's behavior. If your doctor sees that you will give birth when the narcotic effects on the baby are at their greatest, she may give you (or your baby after birth) a drug called a narcotic antagonist, to reverse the effects of the narcotic.

After the pain of labor is over, the pain of delivery begins. Go to the next page to find out about anesthetics available to ease the delivery process.

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