Anesthesia Associates of Southern Connecticut

Anesthesia for Labor and Delivery

Each woman's labor is unique. The intensity of pain is dependent on many factors:

  • your pain tolerance
  • the size of the baby
  • the position of the baby
  • the dimensions of your pelvis
  • the strength of the contractions and the presence or absence of pitocin
  • your previous labor experience


Labor is divided into 3 stages:

  • Stage 1 - from the onset of labor to full cervical dilation (10 cm)
  • Stage 2 - from full cervical dilation to delivery of baby (pushing phase)
  • Stage 3 - from delivery of baby to delivery of the placenta (afterbirth)

Pain from stage 1 labor is primarily due to uterine contractions. Pain from stage 2 is due to uterine contractions plus pain from stretching in the birth canal and vagina.  


By far the most common method to control labor pain used by anesthesiologists at Norwalk Hospital is epidural analgesia. However, there are many accepted ways to treat labor pain. These are listed below:

  • Natural methods - These include Lamaze techniques, hypnosis, massage, warm water, birthing balls, accupuncture, accupressure, soothing music, visual imagery. There is a large body of information on this subject on the internet.
  • Intramuscular or intravascular (IV) injections - Nothing fancy here. These are either old-fashioned shots (intramuscular) or intravenous (IV) injections. They enter the bloodstream and work on the brain to provide pain-relief. Side-effects include drowsiness, nausea, and itching. The medications reach the baby, although in small quantities.
  • IV PCA (patient-controlled analgesia) - This is just intravenous injections of medication, except that the patient controls the injections. Small doses are injected when the patient pushes her PCA button. The machine will deliver a dose no more frequently than every 5-10 minutes, depending on the setting.
    This technique is rarely used for labor at Norwalk Hospital.
  • Epidural for labor pain - This is by far the most common method of pain control for labor at Norwalk Hospital. Click here for a detailed description of this important technique.
  • Spinal narcotic for labor pain - this technique is used infrequently at Norwalk Hospital It is the basis for the "walking epidural" used at some hospitals. A narcotic is injected into the spinal fluid and this provides adequate pain relief for the first stage of labor. However, as the labor progresses toward the second stage, an epidural is usually required.
    We only use this technique when an epidural is not possible. The most common reason we would choose this technique over an epidural is in the patient who has had extensive back surgery (e.g. multiple laminectomies, or spinal fusion with Harrington rods).
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