This is pain associated with giving birth. There are three stages to labor. The first stage starts with the first contractions and ends with complete dilation of the cervix. This is the most painful stage. The second stage is from complete dilation of the cervix to delivery of the baby. This stage is not as painful but requires a lot of effort to push the baby out. The last stage is delivery of the placenta. This stage should not be painful. It is associated with pain if you had a tear or required an episiotomy that is a cut to help the baby come out quicker.

You may attend natural childbirth classes prior to your time of delivery. You will learn a combination of relaxation techniques and breathing as a means of relieving pain during childbirth. You should attend these classes regularly and practice with your partner. The classes will help you understand what is happening to you at any stage in your labor and you will learn how to relax both physically and mentally. Your partner would learn how to help you through eye contact or massage.

There are several different ways of pain relief during labor. Breathing techniques - include different levels of breathing that you can use for the different stages of labor to help you relax, control your body and calm yourself down, as the contractions become stronger.

Deep breathing: This is ideal at the beginning and end of contractions. To check that you are doing it properly, get someone to place his or her hands on your lower back. As you inhale, their hand should move. Deep breathing is calming.

Light breathing: At the height of a contraction you should breathe fast and short. You only aerate the top part of your chest so that you move hands placed on your shoulder blades. Keep your lips slightly apart and breathe in through your throat.

Featherlight breathing: During transition, when the contractions are fast and difficult, yet you are trying not to bear down until the cervix has fully dilated, you should pant to stop yourself from pushing. These breaths are short and rapid, limiting your ability to push downwards, but don't hyperventilate or you'll feel faint. Pant for 15 seconds and then hold your breath for 5 seconds. You can even think the rhythm of the "pant, pant, blow."

Relaxation techniques - include learning to relax your body so that during labor your uterus can contract without the rest of your body tensing up. If you tense some part of your body, such as your fist, and then let go, you can notice the difference. To learn this technique, you give orders in sequence to parts of your body to tense and then release the tension. You will then be able to appreciate the sensation of relaxation and utilize it during your labor.

Tranquilizers - Given in small doses during the first stage of labor, these are designed to reduce anxiety and make you sleepy. The most common tranquilizer in childbirth is Valium. If you fall asleep or are too drowsy, you may wake up confused and unable to get to grips with your labor. These drugs may depress the baby's respiration too.

Analgesics - These are painkillers used to dull the pain. The most common painkiller is Demerol, which is given during the first stage of labor. It will help the pain but sometimes you may have side effects such as nausea or a feeling of unreality. Demerol crosses the placenta and it may make your baby drowsy especially if you give birth 2-3 hours after you receive the medication. Inhalation Analgesia is a mixture of nitrous oxide (laughing gas) and oxygen. You breathe in the gas just before the peak of the contraction and it makes you feel lightheaded. One of the main advantages of this form of pain relief is that it gives you something to do during difficult contractions. Gas analgesia is best used during the first stage of labor. You need all your wits about you at the second stage when you push the baby out. The nitrous oxide does reach the baby but so does the oxygen, so there are benefits.

Anesthetics - Epidural anesthesia relieves the pain but leaves you consciously able to participate in the birth. Local anesthetic or narcotics such as morphine are given through the epidural catheter. The epidural is given by an anesthesiologist and can be used even with C-sections. It will increase the technology surrounding your birth as you will need an IV drip to keep your fluid levels up should your blood pressure fall, a fetal monitor and a monitor to record your contractions. A general anesthetic is only used if you require an emergency C-section. Local anesthetics are used at delivery in case you need forceps or vacum extraction, or when you have a tear or episiotomy stitched. These are administered into the vaginal wall.

Call your Doctor if you are in labor and require pain relief. There are many ways to help you have a relatively pain-free labor.

Note: All medications mentioned on this site--including, specialty compounded ointments such as Capsaicin, Gabapentin, Ketamine, Vitamin E--may be ordered directly from L.A. Pain Clinic.