Pharmacologic Pain Relief during Labor

Labor is a painful process. Pain accompanies labor contractions for a number of different reasons. Uterine contractions, cervical dilatation, fetal descent and perineal stretching are all associated with pain during labor. The level of pain reported by women in labor widely varies. To ensure a smoother birth experience pharmacological pain management may be used. These techniques include the administration of analgesia to reduce or decrease awareness of pain or anesthesia administration that causes partial or complete loss of sensation. To achieve appropriate pain control and maternal satisfaction, it is important to include women in the selection of techniques that is right for them.

Women should receive little systemic medication as possible during labor because most medications given during this time cross the placenta and has some effect on the fetus. However, it is important not to test the limit of her endurance since local anesthesia is available. Women should be greatly discouraged in taking acetylsalicylic acid or aspirin for management during labor. This medication interferes with blood coagulation that increases the risk of bleeding in the newborn and/or the mother.

Goals of Pharmacologic Pain Relief during Labor

  1. Relax a woman
  2. Relieve a laboring woman’s discomfort
  3. Medication administration produces minimal systemic effects on the woman’s uterine contractions, pushing efforts or the fetus.

Medication Administration Preparation

P – Preferences of medication to be used must be discussed with the woman and the partner.

R – Remember the topmost criterium in choosing a drug to be used during labor is patient SAFETY.

E – Educate the woman about the medication to be administered: The type of agent to be given, how it will be administered and what she can expect to happen after administration.

P – Prompt answers to woman’s concern regarding drug administration and labor.

Analgesic and Anesthetic Agents Used in Labor and Birth

Narcotic Analgesics

Narcotics are given during labor due to the potency of their analgesic effect. These medications may possibly cause fetal CNS depression. Hence, it is the nurse’s responsibility to question a physician’s order for a narcotic analgesic if a pregnant woman is in preterm labor. The preterm neonate may have extreme difficulty coping due to possible lung immaturity added with respiration depression after narcotic administration.

List of Commonly Use Narcotic Analgesics

  1. Meperidine Hydrochloride (Demerol)
  2. Morphine Sulfate
  3. Nalbuphine (Nubain)
  4. Fentanyl (Sublimaze)
  5. Butorphanol Tartrate (Stadol)
  6. Meperidine Hydrochloride (Demerol)

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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