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University Hospital of Brooklyn at

Long Island College Hospital

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David Wlody, MD
Chief of Obstetrical Anesthesia and Professor of Anesthesiology
Downstate Long Island College Hospital

The Downstate Diagnosis Archive

The Downstate Diagnosis:
Childbirth Pain And What You Can Do About It

Whether you're pregnant for the first time or a childbirth veteran, chances are you're thinking about managing the pain of labor. You've probably made up your mind whether you'd like an approach involving medication or a non-drug method of pain management. At Downstate LICH, we tell delivering mothers two things: you're the one making the decision, and you have the right to change your mind.

Here are the most common options available:


What it does: Delivers continuous pain relief to the lower part of your body.

How we do it: Under sterile conditions, we insert a catheter into the space around your spine. It usually takes less than 10 minutes for you to feel the full effect of the epidural. When your pain returns, additional medication can be injected through the catheter.

Why you might choose this option: You aren't knocked out, the way you'd be for real surgery. You'll still feel pressure as labor progresses, but not pain.

Spinal Block

What it does: Delivers pain relief to the lower part of your body for a limited time.

How we do it: Under sterile conditions, we inject medication directly into your spinal fluid. You will receive pain relief very quickly, but it will only last a few hours.

Why you might choose this option: If you decide to receive pain relief when your labor is advanced and delivery can be expected within a short period of time, a spinal can be accomplish this more quickly than an epidural. Its disadvantage is that should your pain return, we will not be able to give an additional dose of medication. This is why we often administer what is referred to as a combined spinal-epidural, in which rapid pain relief is provided by a spinal injection, but a catheter is placed at the same time to allow us to provide more medication if needed.

Non-medical Options

What it does: Provides techniques for pain management without the use of any medication. These include water immersion, massage and relaxation exercises such as breathing techniques. Studies have shown that women who have chosen this method are generally satisfied with their birth experience.

How we do it: Provide you with the institutional resources to support your choice. At Downstate LICH, most of our birthing suites have tubs and we encourage a woman's use of doulas and birth coaches.

Why you might choose this option: Many women feel that natural childbirth is best experienced without the introduction of medication.

Everyone reacts to pain differently. No woman can know in advance how she will be able to cope with her labor pain until she experiences it for herself. Additionally, labor in one delivery may be very different from labor in a subsequent one. What's important is the environment in which she is delivering. We respects a woman's wishes at each point of childbirth.

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