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Pain Management

Every pregnant woman hears stories of other births, and often face labor and childbirth with fear and anxiety of anticipated pain.

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That is why preparing for the experience is essential by confronting those fears, marshaling coping skills, gaining knowledge about the process of labor and birth and mustering confidence on the best way to manage the pain of labor.

We can help you:

  • Understand the process of labor and delivery through prenatal education.
  • Build trust in your own instincts and abilities.
  • Work on healing relationships, psychological or emotional problems.
  • Understand that labor pain is like no other, and each person’s experience of pain is unique.
  • Learn how to close your "pain gates."
  • Learn what is manageable and what is unmanageable pain (knowing one's threshold).
  • Learn techniques to treat the unmanageable pain.
  • Educate you on regional anesthesia available should you want it.
What is regional anesthesia?

Regional anesthesia involves the injection into specific areas of the body medications that diminish the transmission or sensation of pain from whole regions of the body. Two common types of regional anesthesia used in obstetrics are Intrathecal narcotics and Epidurals. They have slightly different effects but vastly different side effects.

Despite the fact that in many hospitals in this country 80-90 percent of women receive an epidural in labor, at Cheshire Medical Center, Dartmouth Hitchcock – Keene, we feel that an Intrathecal offers reliable pain relief yet allows functional labor.

Intrathecal Epidural
Technique: Small needle Larger needle
Single shot Catheter left in place for continuous infusion
Medication put into spinal fluid space Medication put into space just outside the spinal fluid space
Placed low in the middle of the back between spine bones Placed low in the middle of the back between spine bones
Medication: Very small doses of a narcotic: morphine, fentanyl, sufentanyl Larger doses of a “caine” medication (in the same medication class as lidocaine)
Duration: 3-8 hours depending upon the combination used. Can be repeated. Lasts as long as continuous infusion is maintained. Sometimes needs boosting.
Effects: Full relief from labor pain often allowing sleep despite continuing labor. Allows the pushing feeling of the second stage of labor. Full relief from labor pain often allowing sleep despite continuing labor. Commonly blocks the pushing feeling of the second stage of labor. Can block the stretching pain from the perineum just prior to delivery.
Common side effects: Itching Difficulty moving legs, loss of leg muscle strength
Occasional side effects: Nausea, difficulty voiding Low maternal blood pressure with fetal heart rate changes requiring blood pressure medications; difficulty voiding; fever and infection; need for forceps or vacuum to assist delivery.
Rare side effects: Respiratory Depression Emergently low blood pressure; inability to breath
Use is associated with: Need for pitocin Need for pitocin
Ability to ambulate, be in the tub, freedom of movement Need to remain in bed