Empower Your Labor: How to Have a Medicated Birth And Love It!

How to Have a Medicated Birth – And LOVE it!

Presented by Heidi Duncan, Expecting New Life Birth Services

Nashville headshot-5


While the answer may seem obvious, there are many reasons women opt for pain medications during labor besides being unable to manage the pain of labor. Anxiety, exhaustion, past trauma, and restrictions created by other interventions may all lead to choosing pharmacological pain relief.


There are non-medicated ways to bring comfort. Prepare to use other options to manage contractions
during pre-labor and early labor, before pain medications are available.
● Hydrotherapy, movement, mental focus (prayer, hypnosis), massage, intentional breathing
● An experienced Birth Doula can help you to go longer without meds, choose the best timing,
and continue active positioning throughout the whole labor and birth
● A Peanut Ball will help with comfortable positioning in bed to encourage labor progress
○ Remember the “Captain Morgan” and “Side-lying/Fetal” positions


1. Epidural / Spinal
a. Given through catheter inserted in spine
b. Numbs the body from waist down
c. Epidural for labor; Spinal for surgery
d. Continuous drip for epidural; single dose for spinal
2. Narcotics (Stadol, Nubain, Demerol, Fentanyl)
a. Given through IV line in hand/arm or into muscle
b. Single, fast-acting dose that lasts 1-3 hours
3. Nitrous Oxide (“laughing gas”)
a. 50/50 mixture of N.O. and Oxygen (different that dental)
b. Self-administered using mask during contractions


1. Epidural/Spinal:
a. Restricts movement; requires remaining in bed
b. May take as long as an hour between request and pain relief
c. Requires continuous fetal monitoring, IV fluids, blood pressure cuff and urinary
2. Narcotics/Opiates:
a. Does not numb pain; may help take some “edge” off of the pain
b. Cannot be given during last 3-4 hours of labor due to negative effects on baby’s ability
to breathe at birth
c. Reduces freedom of movement due to fall risk
d. May require continuous fetal monitoring and IV fluids
3. Nitrous Oxide:
a. Currently available only at 3 facilities in Greater Nashville: Vanderbilt, St. Thomas
Midtown, and Baby + Company Birth Center
b. Requires holding the mask to self-administer


Every options has both benefits and risks. (If you are told that there are no risks, you are not being
given complete information.)
Epidural / Spinal
○ BENEFITS: Numbs body to remove pain sensation; muscle relaxation may help
progress; can allow for rest and sleep; lowers blood pressure, may be helpful for
○ RISKS: Break-through pain or uneven pain relief; muscle relaxation and lack of
movement may slow progress and impede pushing process; may cause fever or
headache; may cause soreness or permanent pain at insertion point
○ BENEFITS: May reduce anxiety; may improve ability to cope with painful contractions;
may cause sleepiness
○ RISKS: Known to impair breathing for newborns; may interfere with bonding and
breastfeeding; may only allow for sleep between contractions; may cause groggy
Nitrous Oxide
○ BENEFITS: Self-administered (can stop and start as desired); fast-acting; leaves system
quickly; does not interfere with labor process; may decrease awareness of pain; may
reduce anxiety; no known side effects for baby
○ RISKS: May cause dizziness or nausea; contraindicated for women with B12 deficiency

Learn more at these helpful websites:
● AmericanPregnancy.org/labor-and-birth
● ACOG.org/Patients/FAQs/Medications-for-Pain-Relief-During-Labor-and-Delivery
● Awhonn.wordpress.com/category/michelle-collins (nitrous oxide myths)
● Scienceandsensibility.org/peanut-balls-for-labor/
● Askdrsears.com/topics/pregnancy-childbirth/pregnancy-concerns/managing-pain-duringchildbirth
● EvidencebasedBirth.com


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