Labor and delivery can be a painful experience. Fortunately, anesthesia is available to ease the pain of labor for women who have vaginal deliveries or cesarean sections. Anesthesia used in labor has to be safe for both mother and baby.There are three types of anesthesia used for deliveries: local anesthesia, regional anesthesia and general anesthesia.
Local Anesthesias
Local anesthesia and pudendal blocks are used right before vaginal delivery to numb the perineum, the vaginal area that stretches as the baby is delivered. Local anesthesia doesn't decrease the pain of contractions but does decrease the pain of delivery and the pain of cutting an episiotomy. Allergic reactions to local anesthesia are possible; blood pressure may drop if the medication is inadvertently injected into a vein.
Epidural Anesthesia
Epidural anesthesia is the most common regional anesthesia used for women in labor. The patient sits up or lies on her side, and a small thin catheter is placed into the epidural space of the spine. Many hospitals today use continuous epidurals, which deliver a constant dose of medication via a medication pump. This prevents anesthesia from wearing off and can also be used if the mom needs to have a cesarean section.
Disadvantages of epidurals are a potential drop in blood pressure, decreased sensation that can slow pushing efforts and the inability to get out of bed and walk after the epidural is placed, although some hospitals offer epidural anesthesia that allows patients to get up. Epidurals can also cause difficulty urinating, may be more effective on one side than the other and sometimes result in a severe headache the next day, according to the Mayo Clinic.
Spinal Anesthesia
Spinal anesthesia is a very fast-acting regional anesthesia used for cesarean sections. Women who have spinal anesthesia are paralyzed from the midchest down for a period of several hours; they can still breathe on their own most of the time, although a sensation of not being able to breathe may occur. Spinal anesthesia can cause severe headache the next due to spinal fluid leakage; women who have spinal anesthesia usually have a Foley catheter to drain urine for a day.
General Anesthesia
General anesthesia puts the patient to sleep; use of a breathing tube and ventilator is required because the patient is given medication to keep her from breathing. Oxygen is administered via the breathing tube, which is placed by an anesthesiologist. General anesthesia is only used in labor during cesarean sections, and generally used only during emergency situations, when there's no time to administer spinal or epidural anesthesia. Examples of this are fetal distress, uncontrolled maternal bleeding or seizures. General anesthesia also sedates the baby, so rapid delivery is essential.
