The anesthesiologist’s goals, when consulted to participate in the care of women in labor, are very much the same as those of her Obstetrical Care Provider:

  • To facilitate comfort during a natural but typically painful process
  • To do so in a way that minimizes risk to both the mother and her soon-to-be-born baby

The American College of Obstetricians and Gynecologists has suggested that: “Labor results in severe pain for many women. There is no other circumstance where it is considered acceptable for a person to experience severe pain, amenable to safe intervention, while under a physician’s care.” Anesthesiologists endorse this belief and, as specialists in the management of acute pain, view labor pain relief as a professional duty and responsibility.

There are many opinions about how to best facilitate comfort in a laboring woman. However, it is the woman, herself, who decides which method is best for her. Usually a pregnant woman will already have a plan for coping with pain before labor begins, and an informed approach is to be encouraged. It is very clear, however, that no two labors are identical, and that the subjective experience of pain can be difficult to anticipate.

The amount of pain a mother experiences depends on many factors.

These include:

  • The size and position of the baby
  • The size and shape of the mother’s pelvis
  • The strength of the uterine contractions
  • Previous experience & expections of labor
  • Other issues which are not well understood

Modern anesthesiology and obstetrics have numerous effective methods that allow a woman to have choices regarding labor pain management.

These choices include:

  • Breathing exercises and relaxation techniques which may include aromotherapy, warm showers, massage, supportive nursing care, a labor ball, etc.
  • Intravenous pain medications
  • Local nerve or field blocks
  • Regional techniques (epidural or spinal anesthesia)

Since each woman’s labor is unique, anesthesiologists advise flexibility in the pain management aspect of labor plans. For example, a woman may have planned a “natural birth” without any medical intervention but then find the labor pain has exceeded her expectations.  She may then decide to use IV pain medications.   Less commonly, labor pain is experienced as less than expected.  In this case, a woman might decide that an original plan for medical pain intervention with a labor epidural is not needed or warranted.

The anesthesiologist can assist a woman and her obstetrical care provider in making individualized choices about pain management.  Working as a team with obstetrical care providers, anesthesiologists have the knowledge and skills needed to help comfort the laboring patient while keeping safety a priority for both mother and baby.