Enjoying Your Pregnancy Guide to Understanding - Brigham and ...

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Your Prenatal Guide
ANESTHESIA AND PAIN RELIEF
Each expectant mother in labor will require different types, as well as different amounts, of medication depending
on her special situation. Patients who have attended “natural childbirth classes” may require little or no pain
medication. Other patients request specific types of analgesia and anesthesia to relieve the pain of childbirth. Our role
in your labor and birth is to safely provide pain relief for labor or anesthesia for cesarean birth, if required.
We encourage all couples to attend a natural childbirth class. This will serve to educate you about the birthing
process and take away fears. The classes will serve every laboring couple, even though they may elect an anesthetic
such as an epidural. Every person has a different tolerance to pain, and you should not feel a sense of failure if you
request anesthesia or we suggest medication for pain relief. There are two major types of anesthesia.
REGIONAL ANALGESIA AND GENERAL ANESTHESIA
Regional analgesia is the most popular method for labor, delivery and cesarean section. The main goal of regional
analgesia for obstetric patients during labor and birth is pain relief with a minimum loss of muscle strength. This can
be done either by continuous epidural analgesia or combined spinal-epidural technique. General anesthesia is seldom
used in obstetric anesthesia at the present time.
Common methods of regional analgesia include:
• Epidural Analgesia - The anesthetic is injected through a catheter in the lower back that produces numbness of the
lower abdomen, legs, and birth canal for pain relief during labor and delivery. A minimum amount of anesthetic is
used for maintenance of muscle power.
• Combined Spinal-Epidural Analgesia - An anesthetic is first injected into the lower back, followed by introduction
of the catheter. With this method, pain relief can be quick and the catheter can be used for further pain relief.
Epidural and spinal anesthesia is usually used for cesarean sections. General anesthesia is used for cesarean sections
during special situations.
• Local and Pudendal Block - The anesthetic numbs the lower birth canal and is given just prior to birth.
• Paracervical Block - The anesthetic is injected into the cervix to partially relieve pain during labor. It is rarely used.
Both the local and pudendal block and paracervical block techniques are administered by the obstetrician.
At Brigham and Women's Hospital, anesthesiologists are available 24 hours-a-day on the labor and birth floor, and
they are happy to answer any questions regarding the pain relief of labor, birth, and cesarean births.
Shaded portion represents typical area of numbness for spinal, caudal or epidural anesthesia.
GETTING TO KNOW YOUR BABY
During your pregnancy, you may have formed expectations about the sex and appearance of your baby. It may be
difficult to adjust these expectations with reality. It may take a while for you and your family to get to know your new
baby. At birth, your baby may have vernix (white, creamy, “toothpasty” coating) on its skin. This has protected your
baby’s skin in the uterus and disappeaars after the first few baths. Baby’s skin may have a normal newborn rash or
appear dry and peeling. The color of your baby’s eyes and skin may change as the baby grows and the amount of
pigment increases. Hair color and the amount of hair on your baby’s head often changes as well. After a vaginal birth,
the bones of your baby’s head may have overlapped to fit through the birth canal. The shape of the head will normalize
in a few hours. Every baby is unique. The first few days and weeks of your baby’s life can be a marvelous adventure as
your baby grows. If you are having difficulty developing a loving relationship with your baby, your obstetric care
provider can help.