Pain is something many women spend a great deal of time planning how to cope with in labor. Some opt to go for more natural methods of pain management, such as breathing and relaxation, while others turn more towards medicinal methods, such as narcotics and epidurals. It is important that if a woman decides she may want to utilize narcotic pain relief in labor, that she educate herself prior to labor to ensure she is able to make the best decision for herself, her situation, and her baby.
Please note that not all pain medications are available in every maternity ward at every hospital. If you are unsure what medications are available to laboring women at the hospital you intend to give birth at, be sure to discuss this with your doctor, or make a call to your hospital’s maternity ward and ask.
Demerol, until more recently, has been the drug of choice for many physicians caring for laboring patients. Demerol has many advantages, acting as both a narcotic and a sedative, it has the power to take the edge off of the pain associated with contractions, as well as relax and sedate the mother, allowing her to rest, which may help promote healthy labor progression. Demerol can be administered orally (but is typically not administered this way in labor), intramuscularly, or through an IV line. A patient with an IV may be given a PCA pump (patient controlled analgesia), allowing them to press a button when they feel they need more of the medication.
There are some distinct disadvantages to using Demerol for pain relief in labor. Demerol may cause nausea, vomiting, decreased respiratory function in the mother, and low blood pressure. Affects on the baby are usually more intense if the mother was administered Demerol within 2-4 hours of the baby’s birth. Demerol has been shown to cause respiratory difficulties in newborns.
Fentanyl is a synthetic narcotic, similar to morphine and Demerol. Fentanyl works quickly providing pain relief, without overly sedating the woman. The affects of fentanyl on the baby are minimal, and babies born to mothers who were given fentanyl for labor pain have been shown less likely to need medications after birth to help counteract narcotic affects that may depress respiratory function.
Fentanyl may cause nausea in both the mother and child, as well as mild to moderate sedation in the newborn born to a mother administered fentanyl in labor for pain management.
Nubain is similar in affect to morphine that works by lessening pain perception. Nubain generally starts working within five minutes of administration. Nubain does not affect the woman’s muscle control, allowing her to still push when needed, and move freely.
Nausea and sedation caused by nubain are usually minimal, leaving the mother more alert and aware than other narcotic options, however, some women do experience sleepiness after being administered nubain. Nubain can cause decreased respiratory function in the mother and baby, as well as difficulty concentrating. Nubain may induce a state of dysphoria (feelings of unhappiness and being unwell) in the mother. Many women find that nubain affected their recollection of the birth afterwards.
Morphine is still used in some institutions, however it’s use for pain relief in labor has been greatly decreased since morphine has been found to significantly reduce respiratory function in newborns.
Stadol is typically administered to a laboring women while in the first stage of labor and is considered to be stronger than Demerol. Stadol acts not only as a sedative, allowing the mother to rest, but “takes the edge off the pain,” as well. Stadol usually begins working within five minutes of administration.
Stadol usually does not cause nausea, and when it does, the nausea is typically minimal. Stadol can cause decreased respiratory function in both the mother and baby, as well as induce a state of dysphoria (a feeling of unhappiness, and being unwell).
Monson, Kristi, and Arthur Schoenstadt. “Demerol and Pregnancy.” Pain Home Page. 22 June 2009. Web. 20 Sept. 2010.
Danforth, David N., and James R. Scott. Danforth’s Obstetrics and Gynecology. Philadelphia: Lippincott Williams & Wilkins, 2003. Print.
“Using Nubain During Labor – Labor and Birth.” Pregnancy Information and More from Amazing Pregnancy. Web. 20 Sept. 2010.
“Using Narcotics for Pain Relief During Childbirth : American Pregnancy Association.”Promoting Pregnancy Wellness : American Pregnancy Association. Web. 20 Sept. 2010.