Main content

    Regional Anesthesia

    There are several different types of regional anesthesia available: dilute local anesthetics, combination narcotics and local anesthetics, or more concentrated local anesthetics alone. Your physician/midwife and anesthesiologist will help you choose which type will best meet your needs, based on your stage and situation during labor and the amount of pain relief you require. Discuss with them the importance of being able to feel the pushing sensations and being able to work with your contractions. Remember, you will be assisted to manage your pain so you will be able to maintain a sense of control.

    Type When/How Given Advantages Possible Side Effects/Disadvantages

    Intrathecal (Narcotic and/or local anesthetic

    Established for labor pain not relieved by other methods.

    Needle inserted into central spinal fluid where medicine is injected and needle is removed.

    Usually gives good pain relief.

    Takes effect immediately.

    Some mothers may be able to walk.

    Does not alter pushing efforts.

    Itching.

    Possible spinal headache (rare).

    Limited time duration.

    Possible infection.

    Epidural Narcotic Only (Walking Epidural)

    Established for labor pain not relieved by other methods.

    Needle inserted into epidural space and small catheter placed for later use (needle pulled out after catheter is inserted.)

    Usually gives good pain relief for early labor.

    Some mothers may be able to walk.

    Able to use catheter for local anesthetic later if needed.

    Itching.

    Often restricts mobility.

    Can become Spinal anesthesia if epidural catheter goes into the spinal fluid when inserted.

    Intravascular injection.

    Blood pressure can drop within the first 30 minutes after epidural is started, so frequent monitoring of blood pressure during that time.

    Possible risk of infection.

    May necessitate vacuum or forceps delivery due to decreased pushing ability.

    May experience spinal headache postoperatively (rare).

    Local Anesthetic Epidural

    As labor progresses, active/transition labor.

    Usually given as a continuous infusion via a control pump.

    Medication easily administered as labor advances.

    Can shorten labor by allowing the mother to relax.

    Mother can usually push with assistance; may feel pressure.

    Medication can be turned down or off during the second stage if necessary to assist with pushing sensation.

    Provides enough pain relief without sedation for Cesarean delivery; allows mother to remain awake during surgery.

    Often restricts mobility requiring bedrest during labor.

    Can become spinal anesthesia if epidural catheter goes into the spinal fluid when inserted.

    Intravascular injection.

    Blood pressure may drop during the first 30 minutes after epidural is started, so frequent monitoring of blood pressure during that time.

    Possible risk of infection.

    May necessitate vacuum or forceps delivery due to decreased pushing efforts.

    Spinal Block

    May be given for Cesarean birth.

    Medication is injected into the spinal canal

    Effective immediately.

    May experience spinal headache postoperatively (rare).

    Itch.