Explore Obstetrics & Gynecology Pain Management
By Your Side Through Labor and Delivery
The Obstetric Anesthesia Service at UConn Health is staffed by a dedicated team of board-certified anesthesiologists, residents, and nurse anesthetists who understand that childbirth is one of the most important experiences in your life, and are committed to making it as safe and memorable as possible. We are available 24/7 to provide support and care throughout your labor and delivery. If you want to contact us ahead of time, please ask your obstetrician to reach out on your behalf, or call us directly at 860-679-7151.
Pain Management Options During Labor
Labor pain is very manageable, and your anesthesia team will be there to help you create a pain management plan that works best for you. Depending on your plan, your anesthesia team will include a board-certified anesthesiologist, a certified registered nurse anesthetist (CRNA), or a resident physician who will provide care under the supervision of your anesthesiologist.
Epidural Analgesia
Over two-thirds of women choose an epidural during labor, making it the most popular and effective way to relieve pain. The epidural is administered by a trained anesthesia specialist who inserts a thin catheter into the epidural space in your spine using a needle after numbing the area. A computer-controlled pump continuously delivers medication, relieving pain for as long as labor lasts.
An epidural is safe for both mother and baby because so little of the medication gets to the baby. If you are not a candidate for an epidural, your anesthesia team will discuss alternative options with you.
Common Questions About Epidurals
Can I walk with an epidural?
No. Because your legs will be partially numb and weaker, you will not have the strength or coordination to walk around safely. You will need to stay in bed, and a catheter will be placed in your bladder since you won’t be able to get up to use the bathroom.
What are the side effects of an epidural?
- Incomplete pain relief: While we aim for perfect placement, epidurals may not provide complete pain relief. Your clinician may need to inject different medications, adjust the catheter, or replace the epidural should this occur.
- Spinal headache: About 1% of patients may develop a spinal headache, which typically improves when lying down. Although uncomfortable, it is rarely dangerous and can be effectively treated.
- Low blood pressure: Epidurals can cause your blood pressure to drop slightly. About one-third of women will need medication to help maintain normal blood pressure during labor.
Can an epidural cause permanent back pain?
Due to the nature of the procedure, epidurals can cause localized back pain, but there is no scientific evidence that they cause long-term back pain. There is no scientific evidence that epidurals cause long-term back pain. Even women with a history of back problems are usually still eligible for an epidural.
Will the epidural harm my baby?
Epidurals have been extensively studied and are considered safe for both mother and baby. Only a very small amount of the medication reaches the baby.
Is there a risk of paralysis from an epidural?
While theoretically possible, permanent nerve injury or paralysis is an extremely rare complication. Patients are screened for risk factors, and the procedure is performed by trained professionals, making it very safe.
Do I have to stay completely still during the epidural?
While it is important to remain still while the epidural is being placed to ensure safety, we are experienced in working with patients who are in labor and in pain and moving around. We will typically time the placement between contractions. This is rarely a problem.
Can everyone have an epidural?
Most women are good candidates for an epidural. Your anesthesiologist will review your medical history and determine if it's appropriate for you.
IV Medications
Pain medications administered through an IV can help alleviate some pain during labor, especially in the early stages. There are no issues with receiving an IV pain medication before getting an epidural, if that’s part of your plan. Butorphanol (Stadol®) is one of the most commonly used IV medications. It is often preferred because it’s considered safer for both the mother and baby compared to other narcotics.
Nitrous Oxide
Nitrous oxide, or “laughing gas,” is a tasteless, odorless gas mixed with oxygen and inhaled through a mask during contractions. You control the mask by putting it on during a contraction and taking it off afterward. Nitrous oxide won’t eliminate pain, but it will help take the edge off. The effects are brief and wear off quickly after the mask is removed. Side effects may include mild lightheadedness or nausea, but these are temporary. Nitrous oxide is safe for both mother and baby.
Remifentanil PCA (Patient-Controlled Analgesia)
Remifentanil is an ultrashort-acting opioid that, despite its strength, is safe for both mother and baby. It’s a strong alternative for those who want significant relief but may not be a candidate for an epidural. This medication is delivered via a specialized pump that allows you to control how much you receive. The effects last as long as a single contraction, offering quick relief. Although it doesn’t provide quite as much relief as an epidural, it’s still a good option for managing pain during labor.