Oct 16, 2015 3 min read

DEAR DOCTOR K: I’m about to have my first baby. Can you tell me about medications that may be used during childbirth? Will they pose any risks to my baby?

DEAR READER: Many medications can be given for pain relief during childbirth. Other drugs may be given to assist your labor.

The pain medicines may not stop pain completely, but they will greatly lessen it. Narcotics such as meperidine (Demerol) are frequently used to relieve labor pain. If a baby is born soon after a mother receives any narcotic, the baby’s rate of breathing may be slower than normal at birth. This effect generally is short-term. If it occurs, it can be reversed with an anti-narcotic drug.

Anesthetics are medications given during labor to numb you from the waist down. They do not put you to sleep. Anesthetics can be given as an epidural or a spinal injection.

Epidural anesthesia is the most common type used for pain relief during labor. But because it numbs you from the waist down, it can prolong your labor or diminish your ability to push out your baby. It numbs the nerves that do the pushing as well as the nerves that feel pain. This may lead your doctor to use a vacuum or forceps to help deliver your baby. Spinal anesthesia is used as an alternative to epidural or general anesthesia when cesarean delivery is needed.

Epidural medications can lower your blood pressure; they also can temporarily slow the baby’s heartbeat. If this happens, raising your blood pressure with fluids or medication will almost always fix the problem.

Sometimes medications must be used to speed up or start labor. There are many reasons why labor may be induced rather than waiting for it to begin on its own. These include concerns about the mother’s or baby’s health.

Oxytocic medicines may be used to induce or speed up labor. The one most commonly used is called oxytocin (Pitocin). It is used to help contractions begin if there aren’t any. It is also used to increase the frequency of contractions when fewer occur naturally.

The dose of oxytocin will be adjusted to allow relaxation between contractions. Relaxation is needed to ensure that a fetus receives enough oxygen during labor. If the fetal heart rate suggests that the baby is not getting enough oxygen, the oxytocin dose may be reduced or stopped.

Prostaglandins are given to help with the process of inducing labor. If you need this type of drug, your vital signs (heart rate, breathing rate, blood pressure) will be closely monitored.

For most of human history, women simply gave birth; there were no medicines for pain or to speed labor. Today, we have medicines and tools for monitoring what is happening with both the mother and the baby, and that allows the doctor to safely adjust the doses of the medicines used. Be glad that your first baby will arrive in the 21st century!

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)