Hospital Pain Relief Options for Birth: IV, Nitrous, or Epidural?

Labor is likely going to be a little bit painful. I remember the first patient I had who was like Hilary, this is painful. I didn't know it was going to hurt. And I was shocked. So first off, labor is likely going to be a little bit painful. But a lot of times we don't talk about all of the different choices that you have surrounding pain in the hospital. There are a few different ones. I know the epidural gets top billing, but let's talk about some of the other choices that you're going to have. This is part of my choices series. I feel like a lot of people get a doula because they just think they're going to help them offer different choices. And I am here to give you the different choices about pain management in labor. There's other choices that you guys can find. I'll put the playlist of the choices videos down below. Now, I love that you are thinking about different choices. I think that is so important. And it's actually why I recommend that couples go through a birth plan ahead of time. I have a whole free birth plan series that I'm going to link down below for you. Okay, there are three basic different options for medical pain management in the hospital. And the first one people do not talk a lot about, but my first hospital that I delivered at, I use this more than almost anything else. So it's something that I'm really well versed on and it is IV pain medicine. Now it is really important that you understand a few things about IV pain medication. And the first one is that the first dose is an absolute banger. It is amazing. You feel really good. You're able to get some rest and people absolutely love it. And they this thing is going to take me into delivery. Then they ask for the second dose of medication. Of course, my patients have already educated them about this, but not every nurse is as good at that. The second dose is given and they're like, oh, it's not quite as good, but I'll take it. It's pretty darn good. It does help them relax. You know, hopefully they can get some rest between contractions. You do need to know that with IV pain medication, it is not going to numb the contractions, but it is going to take the edge off. So a lot of times people will be uncomfortable during the contraction, but can rest between contractions. Or if you're in early labor, you may be able to kind of rest between the whole thing. A lot of people compare it to taking a strip drink that just takes the edge off. So back to second dose works pretty darn good. But the third dose I put it in and they're like, Hillary, when are you going to give me the pain medication? Because your body becomes tolerant to it that quickly. That means that it just isn't effective anymore. So if people are looking for IV pain medication to get them to delivery and they're three centimeters, I'm usually educating them on the fact that it is really not going to work for that long of a period. So you got to think you've got two good doses of the IV pain medication, and then you're going to want to switch to something different. Now, every hospital seems different on the medications that they give. I've seen some giving Demerol or morphine places that I've worked have given fentanyl and stayed all, and it all seems very provider specific. They have one that they like to give. Now, the other thing is that it is going to make you sleepy when we give the IV pain medication, but it is also making the baby sleepy inside the womb as well. And when your baby comes out, we don't need them to take a nap. We need them to cry and get all of that amniotic fluid out of their lungs. So it is important that we not give you the IV pain medication right before delivery. Now, this comes more into play if you've already had a baby, usually around eight centimeters, we're cutting off IV pain medication because we don't want the baby to be sleepy because of it. If it is your first baby, a lot of times I can give IV pain medication up until the point that you're complete because you still most often have an hour or two of pushing ahead of you. And that is enough time for it to wear off for you and baby. And yes, that means that it only really works for one to two hours kind of depending on how your body uses the medication. So that's something to know as well. The next one is nitrous oxide. So it's very similar to IV pain medication in that it takes the edge off. And yes, this is exactly what they're using in the dental chair in case you've had that before. The good news about this one is it is out of your system very quickly because you breathe it in and then you breathe it out within minutes, it is out of your system. So we don't have that concern of, you know, once you hit complete or nine centimeters, you can't have it anymore. You can really have it up until delivery. It's really important that the pregnant patient control the nitrous oxide. Your partner cannot be holding it on your face because if you were to fall asleep, we want it to fall off of you so that you're not overdosing yourself on nitrous oxide. That's something that not a lot of people know. And again, it's just going to take the edge off. It can be enough to help you relax before you end up having your baby. And one thing to know about all these different things is that once you get to complete or 10 centimeters, it actually feels really good to push. So a lot of times people only need that pain management up until they're able to push and then pushing feels good and they don't need it as much. As a note, not every hospital uses nitrous oxide. So check with your hospital. It's a great question to ask on your hospital tour, or you can just call in and say, Hey, is nitrous oxide available at your hospital? I know a lot of people are really excited to use it, but when they get to the hospital, they find that it's not as helpful as they were hoping. So that's something to know just in advance. I'm not here to scare you about it. I'm just here to inform you. Editor Hillary is here to say that I'm going through all of these and you're probably like, why, why is this helpful? And a lot of times when you get in labor, you just start to really tense up around the pain. Think about a time that you were really in pain. Don't you tend to like tense up about it? And so we're giving these medications mostly to help you relax, which will hopefully help your cervix and the birth canal to relax at the same time. That's why I keep saying for IV or nitrous, it just helps your body to relax. So that's one of the big goals of those two is to help you relax, help the cervix open, help baby descend into the birth canal. Now the final one in here is the epidural. Now I have a bunch of videos on that, but I'm going to give you some quick cliff notes about that. You need to know that it lasts or it's supposed to last until delivery. There are risks associated with it. It's a little bit higher risk than IV pain medication or nitrous oxide. And the anesthesiologist will view those with you before you have it. And it also takes an anesthesiologist. So sometimes you kind of have to line up for an epidural, or if they're in a C-section, it takes a little bit of time to get the epidural versus nitrous or IV pain medication. Your nurse can give it. So there's no like lineup time. And then of course you have natural pain management techniques. I always recommend that every couple know some natural pain management techniques, even if you're planning on an epidural, and then practice those as you head into delivery. I actually have a birth class that I recommend that has a whole natural pain management bonus video. And I'm going to put the link for that one down below. It really helps couples get ready for all of the things that they're going to be facing towards birth, including what pain management they're going to want to choose. Now, some of you may have more questions about the epidural. And honestly, I think everyone should learn some about the epidural because you may end up needing to get it during your pregnancy. I have a whole epidural frequently asked questions that I'm going to link up above. Thanks for joining us here at The Pregnancy Nurse, where we're sharing choices and getting you prepared, not scared for your upcoming hospital birth.