Labour Analgesia

Pain is a subjective and varied phenomenon. In the first stage of labour, pain arises primarily from nociceptors in uterine and perineal structures. Nerve fibers transmitting pain sensation during the first stage of labour travel with sympathetic fibers and enter at the T10-L1 spinal segments. In the second stage, fetal descent with subsequent distention of the pelvic floor results in somatic pain impulses primarily through the pudendal nerve (ACOG, 1996). Other factors such as patient ability and choice to receive pharmacological pain management, labour support, risk level of clinical situation and provider influence can impact a woman’s pain experience.

There are typically three pharmacological choices for labour analgesia in Nova Scotia hospitals offering obstetrical services. These include: epidural, intravenous or intramuscular opioids and inhaled nitrous oxide.

		Labour Analgesia - Guidelines for Obstetrical Practice
		Addendum, November 2005