Whether a mother opts for a natural birth or an epidural, it’s important to understand the medicines that may be administered during labor before labor occurs. Knowing the terms doctors and nurses may be using and understanding the effects of potential interventions can help parents can feel comfortable and confident making decisions, especially if there are unexpected changes during childbirth. Below are common interventions that may be used during labor and birth and their effects on mom and baby:
Epidurals, Anesthesia and Spinal Blocks
An epidural is the local anesthesia administered just outside the membrane that surrounds your spinal cord and spinal fluid. Epidurals are the most common pain relief for laboring mothers and while there are differing opinions on the effect epidurals have on baby, they are considered safe for baby’s health.
Temporary side effects of epidurals are heavy shivering, a ringing of the ears, backache, nausea or difficulty urinating. These are also considered harmless to mom and baby. Because they are used to dull the intense sensations of labor, an epidural may also slow contractions. Also, since the epidural travels to the baby through the umbilical cord, there are reports of babies born to moms who have had epidurals taking longer to get into position for birth, causing a potential rise in the chance of having a c-section.
A spinal block is the term for the regional anesthesia used to numb a birthing mother from the belly down. This is the intervention used for c-section birth since it means that mother cannot move or feel any sensation in that area. Because a laboring mom won’t be able to feel anything from the belly down with use of either type of anesthesia, a Foley catheter will be inserted into the bladder to drain urine.
Oxygen is administered through an oxygen mask to laboring moms and helps mother deliver oxygen to baby. The oxygen mask might be given if baby’s heart rate is dropping due to fetal distress during labor. This can be scary but the good news is that giving oxygen is common and It has not been shown to have adverse effects on baby or mother.
Pitocin is a synthetic version a natural hormone called Oxytocin. It’s a stimulant commonly given to induce or strengthen contractions but may also be given after an epidural because the epidural has slowed labor.
It may also be given after birth to ensure mother does not hemorrhage to help the uterus contract back to its non-laboring state. Pitocin is generally considered safe for mother and baby but there is concern by the American College of Obstetricians and Gynecologists (ACOG) that, if overused, it could potentially cause unnecessary problems during labor and early breastfeeding.
Common side effects of Pitocin may include nausea, stomach pain and runny nose or sinus pain. Rare side effects may include confusion, slurred speech and headache. The doctor must be notified immediately if any of these side effects are present.
When Pitocin is administered, Labor & Delivery nurses watch to be sure that contractions are not occurring too severely or too frequently. Contractions that are too strong or occurring too quickly can cause uterine rupture, meaning that the uterus tears creating a danger to both mother and baby. There is typically a 1:1 nurse to mom ratio when Pitocin is administered to ensure the laboring mom and baby are safe and monitored correctly.
Percocet is the most common medication given to help mothers with pain management after delivery. It is an opioid. Most opioids are not advised for nursing newborns, so when possible, sticking to NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Advil or Motrin) for pain relief is preferred.
For moms who have undergone a cesarean or who have had a difficult vaginal birth, Percocet is appropriate to help with this level of pain.
For mom’s whose goal is to nurse right away, the best thing to do is to nurse before Percocet is administered. If mom and her doctor decide that nursing on demand is okay on Percocet, the main thing to do is to watch baby for marked drowsiness. For a full-term, healthy baby, there will be side effects like sleepiness, but no lasting effects.
A nursing mother may also choose to pump while Percocet is in her system. The milk can be saved for use when baby is 6 months or older. Once baby is past the newborn phase, the effects of opioids decrease.
It’s important to note here that if parents choose early formula supplementation so that opioids do not travel to baby, it is still very possible for mom and baby to then have exclusive breastfeeding relationships.
Our hope is that this list helps parents-to-be become familiar with the terminology and basics of common interventions and medications given during birth. Helping them to feel confident, in control and prepared should the unexpected arise and they hear doctors and nurses using these terms.
This article was written under the direction of present and former Let Mommy Sleep Labor & Delivery and NICU Registered Nurses but as always, mother’s primary care physician is the authority on her care.