All About Labor Medications
As you probably might expect, pain relievers (at least the ones that are safe for use during labor), aren't particularly effective for labor pain. You can't expect to pop a few Tylenol® and breeze through contractions with ease. Pain relievers might be given in the form of tablets or capsules, injections, or even nasal sprays.
In general, it's felt that the medications that cause drowsiness are most useful when the mother needs to get a little rest. At most, they can take the edge off the pain, but they usually don't relieve it to a significant effect.
In general, medications that cause drowsiness shouldn't be given if delivery is likely to happen soon, as they can slow down the baby's breathing and reflexes after birth.
Usually, a "local" is a small injection given just before an episiotomy -- that is, if you're lucky; sometimes there isn't enough time to administer local anesthesia. A local anesthetic won't help with contractions, and it isn't expected to affect the baby. A local anesthetic basically numbs a small area for a relatively short period of time. Local anesthetics are also used if you tear and need stitches, or when forceps or vacuum extraction may be necessary.
Regional analgesia for labor and delivery is very popular, for several reasons. The most commonly used options in this group include epidurals and spinal blocks. When done properly, regional analgesia will provide pain relief in a limited area of the body -- hopefully, including your belly and perineum -- without causing you to lose consciousness. Spinal blocks work fast, but don't last long, which makes them great for C-sections. Epidurals start working a bit more gradually, but can provide long-lasting relief, which is great for long labors.
A combination spinal-epidural block can provide the best of both worlds, offering quick, long-lasting relief, often with more ability to move around, at least in theory (if you weren't already hooked up to a host of different machines and IV lines), and is often called a "walking epidural."
There may be a number of reasons why you don't get an epidural or spinal block, even if you want one. You may be progressing in labor too quickly, or you may have arrived at the hospital or asked for an epidural too late. You might not be a good candidate because of medical problems, such as bleeding disorders, infections near the epidural site, or if you have recently taken certain blood-thinning medications.
Regional analgesia can decrease your labor progress and might interfere with your ability to push, especially if you've lost quite a bit of sensation. Sometimes, it can cause a sharp drop in blood pressure, which is the main reason you will be required to have an IV in place before getting an epidural or spinal. Also, "spinal" headaches are a fairly common side effect. They aren't particularly dangerous, but can make you absolutely miserable. In rare cases, serious problems may also occur.