Obstetric Anesthesia

The University of Maryland Medical Center (UMMC) Obstetric Anesthesia team knows the birth of your baby is a very special time. Anesthesia specialists work on the UMMC Obstetric Care Unit every day. If a patient has medical issues that affect options for pain control, the OB doctor or midwife may ask the team to meet you earlier in pregnancy.

Labor Pain

Each woman’s labor is unique. Labor pain also feels unique for each woman. For some, the pain is manageable. Other times, pain medicines are helpful.

How strong your contractions are
Your baby’s size
Your baby’s position
Your past experience with pain
Your beliefs and fears about labor

Types of Pain Relief

Natural Pain Relief

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How can pain be treated without medicine?

Deep breathing
Warm showers
Heating pads
Massage therapy
Counter pressure
Changing position (walking, standing, sitting, rocking)
Using a labor ball

Intravenous (IV) Medicines

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Sometimes labor pain is too strong. Medicines to provide pain relief are often given by injection into an IV.

IV medicines are used in early labor to:

Decrease the level of pain
Make contractions more bearable
Make the patient feel sleepy

Nitrous Oxide (Laughing Gas)

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Coming soon!

Breathing nitrous oxide can help decrease labor pain
Nitrous oxide and oxygen are administered through a facial mask
Patients breath the laughing gas during contractions and breaths of normal air between contractions

Epidural Anesthesia

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An epidural procedure is the practice of injecting medicine into the back of the patient to numb the lower part of the body. Medicines injected into the epidural space do not make the patient sleepy. Anesthesia experts administer these special medicines.

Epidural Anesthesia procedure

What is it like to have an epidural?

Less intense labor pains
Legs feel weak/heavy
Pain relief without feeling sleepy
Still feeling tightness and pressure with contractions

When can I get my epidural?

Usually done during active labor
Speak with the OB doctor, a midwife and an anesthesia doctor about timing
If the child is crowning, it may be too late for an epidural

How are epidurals done?

Support person goes to the waiting room
Sitting on the edge of the bed the patient will arch their back into a C shape (see picture)
Anesthesia specialists will numb the patients epidural space
The patient will feel pressure in their back while the specialist locates the epidural space
The anesthesia specialist will put in a thin plastic tubing (epidural catheter) into the epidural space
Once the tubing is in place the needle is removed
The anesthesia specialist will connect the epidural tubing to a medication pump
Epidurals can take 15 to 20 minutes
Epidural medicines take between 5 and 10 minutes to take effect

What does the nurse check after the patient receives an epidural?

Numbness
Pain levels
Blood pressure and heart rate
Ability to urinate

What are some epidural side effects?

Feeling itchy
Shivering
Hard to pee on your own
Low blood pressure
Uneven pain relief
Back pain
Headache
Bleeding or infection at injection site
Nerve damage (extremely rare)

The health care team is prepared to treat any and all side effects.

Spinal Anesthesia

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Spinal Anesthesia is used for cesarean section (C-section) and is very similar to an epidural procedure.

The spinal needle goes past the epidural space and into the spinal fluid
Spinal medicine makes the lower body numb and weak
Spinal anesthesia can make the patient numb enough to have surgery while conscious without pain

General Anesthesia

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A cesarean section (C-section) is when a baby is delivered with surgery instead of labor. When a spinal or epidural cannot be done, the back-up option is general anesthesia (“going to sleep”).

This is when the Obstetric Anesthesiology team uses medicine to put the patient under until the C-section has been completed.