8 Myths About Managing Labor Pain

Childbirth can no doubt be painful -- but not as bad as many women anticipate.

If there was a list of the most physically painful life experiences for women, childbirth would likely rank at or near the top. Countless movies and TV shows have depicted giving birth as being excruciatingly, bring-on-the-drugs painful. Experiencing labor can no doubt hurt -- but for many women the discomfort wasn't as bad as they had anticipated, according to a nationwide survey of first-time moms conducted by the American Society of Anesthesiologists. Nearly half of the moms surveyed -- 46 percent -- said the pain they experienced giving birth to their first child was better than they had expected. "Most women who are having their first baby don't know what to expect. Women tend to fear the worst," says Dr. Paloma Toledo, an assistant professor of anesthesiology at Northwestern University in Chicago. "There are studies showing the pain of giving birth is the worst pain women will experience in their lifetime, but for many women, the pain isn't as bad as what they feared it would be. Furthermore, the reality is, there are many safe and effective options for managing your labor pain." Here are eight myths about managing labor pain.

1. You'll need the most powerful drugs available to get through labor.

Among women of normal weight, 32 percent who gave birth delivered without an epidural, according to new research published in June in the journal Anesthesiology. During an epidural, an anesthetic is injected into the delivering woman's lower back to mitigate the pain of childbirth. The anesthetic is delivered through a small flexible tube that's taped to the back, Toledo says. Medications are delivered through the epidural until delivery, allowing for small, additional doses of medication to be delivered at different intervals, if needed. However, "having an unmedicated labor is an option," Toledo says. "You do not necessarily need to have powerful drugs to have a baby." Still, if the labor pain is more than you want to tolerate, ask your doctor what pain management techniques are available.

2. The baby will get the medicine the mom is receiving and that could be detrimental to the newborn.

The medicine physicians provide to ease the mother's pain during labor does not reach the baby, says Dr. Ruth Landau, director of obstetric anesthesia at Columbia University Medical Center in New York City and the director of the Center for Precision Medicine at the department of anesthesiology at Columbia University College of Physicians and Surgeons. In fact, such medication can help the baby because mitigating the mom's pain keeps her body's response to stress in check, Landau says. The release of stress hormones could be detrimental to the child, she says, potentially reducing blood flow to the baby, which would lower the oxygen supply to the baby's brain. An insufficient supply of oxygen, even for a few minutes, could negatively affect the infant's brain function, Landau says.

3. You can only choose one pain management option for your delivery.

Women in labor can take a variety of measures to ease their pain, Toledo says. They can try one approach, and if that doesn't work, move on to a different option. "You don't have to commit to just one method," she says. There are a number of pain management approaches that don't involve medication, such as using breathing techniques or giving birth in a tub filled with water. Another option is nitrous oxide, which is commonly known as "laughing gas" and is used by some dentists. Women can of course opt for an epidural or choose an injection of opioids, which is an intravenous patient-controlled opioid analgesic -- so named because the patient can press a button and release doses of opioid medication. "It's not common in the United States," Landau says. "Relatively few women get this option. We don't offer it unless women can't get an epidural." A woman may not be able to get an epidural if she has a clotting disorder, because a needle in her back could risk complications, Landau says. The caveat with using an opioid is that if it's injected too close to birth, it can make the baby sleepy, which might affect the newborn's breathing. In rare cases, the doctor would have to intervene to help the baby breathe.

4. You can't have an epidural early in labor.

Some women believe getting an epidural early in labor will slow the process and could lead to complications with delivery. Neither of those things are true, Landau says. "There's no reason to avoid getting an epidural early in delivery," she says. In fact, getting an epidural early in labor could be beneficial to a patient with conditions such as cardiac disease or high blood pressure, because the anesthesia keeps the mom's stress response in check, Landau says.

5. Pushing in labor causes more pain than uterine contractions.

A good proportion of women believe that pushing in labor will hurt more than uterine contractions. But many moms feel relief when they're at the point in labor where they can actively participate, says Dr. Stephanie Zeszutek, a board-certified OB-GYN with the Touro College of Osteopathic Medicine in Middletown, New York. "Although pushing can be a 'laborious' process, women know they are on the home stretch to seeing their baby soon," she says. "Some women worry that when the time comes they won't be able to push because it will be too painful. However, when they get the opportunity to finally push, they feel empowered in this uncontrollable labor and delivery event. At that point, pain becomes secondary; they're less concerned about that and more focused on the pushing."

6. The pain management approach that worked for the first childbirth will be good for subsequent ones.

The pain management approach that worked for a woman for her first childbirth may not work for subsequent labors. Each woman may experience labor pain differently, and you cannot predict the level of pain even for the same women in a subsequent pregnancy, Zeszutek says. "A first pregnancy may be extremely painful and the mom might be nervous about going into labor for her second child, but it can turn out to be quicker and much less painful," she says. "Unfortunately, the reverse can happen, where the second pregnancy may turn out to be more painful than the first."

7. Every woman receives an episiotomy during birth.

An episiotomy is an incision or cut on the perineum -- the tissue between the vaginal opening and the anus -- of the mom, which delivering health care providers do to help increase the size of the opening for the baby to pass through. Some women believe they'll need an episiotomy when they give birth, but that's not necessarily true, says Julie Maher, a registered nurse and clinical instructor of nursing at Carthage College in Kenosha, Wisconsin. In the past, an episiotomy was believed to help prevent more extensive vaginal tears during childbirth, and to allow for better healing than a natural tear, according to the Mayo Clinic. But routine episiotomies are no longer recommended. Health care providers may recommend the procedure if your baby is in an abnormal position, is large or needs to be delivered quickly, according to the clinic.

8. If you have a lower back tattoo, you shouldn't get an epidural.

Some women believe that if they have a lower back tattoo, they shouldn't get an epidural because the ink will end up in the epidural space and cause inflammation or an infection that could harm the mother, Toledo says. But "there's no evidence having an epidural will cause this for women with tattoos," she says. "It's perfectly safe."

Ruben Castaneda is a Health & Wellness reporter at U.S. News. He previously covered the crime beat in Washington, D.C. and state and federal courts in suburban Maryland, and he's the author of the book "S Street Rising: Crack, Murder and Redemption in D.C." You can follow him on Twitter, connect with him at LinkedIn or email him at rcastaneda@usnews.com.