7 Things to Know About Painkillers During and After Childbirth

This article was originally featured on What to Expect, a pregnancy and parenting brand helping every parent know what to expect, every step of the way.

Newborn girl sleeps in her mom arms at hospital Sant Pau from Barcelona
Getty | Mayte Torres

Do you have to take the drugs offered to you to relieve the pain of labor and delivery and what's right for you? Here's the deal on painkillers and childbirth.

Pain is par for the course during labor and delivery, and what makes it bearable is the prize at the end: that beautiful baby you'll be holding in your arms. The other thing that makes it manageable? The painkillers you'll be offered during and after childbirth.

But how can you decide what's right for you and do you have to take the medications given to you by your doctor? Here are seven things to know about taking painkillers during labor and after you have your baby.

1. Anesthetics are the most popular form of pain relief for labor and delivery.

For the better part of the last century, anesthetics, or substances that cause partial or complete loss of sensation, have been used for labor and delivery both in the U.S. and other parts of the world. In fact, if you delivered a baby back in the '60s, chances are the only thing you'd remember is being put under anesthesia and then waking up with a newborn in your arms (along with grogginess, nausea and a sore throat from the endotracheal tube).

Though there are two types of anesthesia, general and regional. General, like the kind you'd be given during a major surgery, is rarely used (only in cases of emergency), since it puts the entire body and mind to sleep. Today it's not commonly used for childbirth unless you're having an emergency C-section. Additionally, it's only given at the tail-end of labor to minimize the amount that makes its way through your system to your baby.

2. The epidural is the most popular form of anesthetic used during labor and delivery today.

A full two-thirds of laboring women delivering at hospitals elect to have an epidural, and for good reason: It's considered one of the safest methods of pain relief, since only a small amount of medication is required. That means your baby is hardly being exposed to even a trace of the drugs and is unaffected by it.

The epidural is delivered through a catheter that's injected into your back and can take 15 minutes or longer to kick in. While it does produce numbness, it's limited to your lower body, so you're still fully awake and most likely able to participate in pushing out your baby.

3. If you don't want an anesthetic, you can opt for an analgesic.

What's the difference? An analgesic is a drug that takes away your pain, aka a pain reliever, while an anesthetic is a drug that creates a lack of sensation so you can't feel the pain.

There are several different kinds of analgesics, one being Demerol, or meperidine hydrochloride. Demerol is an opiate that's used for many types of labor and delivery, including vaginal births and C-sections, along with episiotomies and the removal of the placenta. It's typically given as close as possible to actual labor — often two to three hours before the estimated time of birth.

While the drug affects everyone differently, most patients feel drowsy, relaxed and sometimes slightly nauseous. Since it enters your bloodstream, your baby will feel some of the effects too — and may even experience a drop in heart rate. Other opiates used during labor include morphine (though less common today), oxycodone, stadol, fentanyl and nubain.

4. Larger hospitals have begun offering nitrous oxide during labor.

While nitrous oxide, or "laughing gas," is generally not used in the U.S. during labor (it's used in only about 1 percent of women in the U.S.), it is being offered in some of the bigger hospitals and medical centers. It's also popular in other countries, including the U.K., Australia and Canada, where more than half of laboring women rely on the drug for pain and anxiety relief. When breathed in, the narcotic produces slight feelings of euphoria and relaxation, along with detachment from what's really going on (i.e. labor and delivery) — though it doesn't totally eliminate pain or completely numb any areas of the body.

So why isn't it more widely used in the U.S.? Though experts agree that the clear, colorless gas, which usually contains 50 percent oxygen, is relatively safe in small amounts, research is still ongoing and unclear. Past studies have found that nitrous oxide has no effects on the health of a baby at birth, though many of those studies aren't conclusive and have some flaws. That's why it's only offered at a small fraction of U.S. hospitals. If you're interested in learning more about it, ask your health care practitioner whether it's an option.

5. Your doctor will likely prescribe you an opioid after a vaginal and C-section delivery.

Whether you delivered your baby vaginally or via C-section, chances are, your doctor will prescribe you a nonnarcotic, like ibuprofen or acetaminophen, as well as a narcotic, like hydrocodone (Vicodin) or oxycodone (Percocet). All are prescribed for the purpose of relieving the pain you will likely still experience for at least a few weeks postpartum. You can also discuss over-the-counter pain relief medications with your doctor, who can provide proper dosage recommendations.

6. You're not required to take the pain medication given to you after childbirth.

If you're not comfortable taking medications, especially ones stronger than the type you're used to taking for a headache or cramps, for example, you don't have to. The purpose of these pain relievers is to do just that — relieve your pain. If you're a tough cookie who can pull through without the help of medication, all the power to you. There are plenty of alternative and complementary approaches to medicine, including acupuncture, acupressure, biofeedback, massage, reflexology, chiropractic medicine, aromatherapy and hydrotherapy, among others. Ask your practitioner about these holistic approaches if you'd prefer to hold out on medication for as long as possible. And if you're one of the lucky ones who doesn't feel much or any pain after giving birth, you may not have to do anything.

7. Most over-the-counter and prescription painkillers are safe for breastfeeding.

While it's true that what you eat, drink and consume while you're breastfeeding makes its way to your milk supply, where it can then be transferred to your nursing baby, it's important to remember that your baby only gets a tiny fraction of what you put into your body. For this reason, most drugs in their appropriate dosages are found to have no effect on a nursing baby, though few may have a mild, temporary effect and a handful may, in fact, be harmful. To play it safe, ask your doctor which pain relievers he or she recommends that you take while you're breastfeeding.

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