Choices for Pain Relief

Pain relief for a vaginal delivery can be achieved in a number of ways. Some patients will require no anesthesia. For those who do, the goal is to match the patient’s wishes with the requirements of the delivery without subjecting either mother or fetus to unnecessary risk. Ideally, the patient should have been familiarized with the options for labor analgesia during prenatal childbirth classes. With the onset of labor, a patient may be in such pain that a clear explanation of the risks/benefits of each option may not be possible. A history and physical exam are done to rule out conditions that may complicate (hypovolemia, scoliosis) or contraindicate (coagulopathy, patient refusal, infection) placement of a neuraxial block epidural or spinal anesthesia.