Pain relief techniques vary

It's in the back of every woman's mind: How much will it hurt, and can I tolerate it? Pain during labor is as variable as the women who have it; no two women experience labor pain the same way. Pain can be experienced as more or less intense, depending upon:

How tired you are.
How tense and anxious you feel.
What your attitudes are, and how much you fear pain.
Whether you are alone.

Just as pain is variable, so are the many options when it comes to pain relief. Although you may have preferences about pain medication, sometimes you won't know until you actually are in labor what the best choices will be. Some hospitals don't offer all types of pain medication, so it's best to check this out ahead of time.

No feeling versus lessened pain

There are basically two kinds of pain relief: analgesia and anesthesia.

Analgesia will help relieve the pain, but won't always completely remove it.

Anesthesia, which comes in many forms, will cause you to lose feeling in parts of your body while remaining conscious. The exception is general anesthesia, which will put you to sleep. Here are some common kinds of pain medication you may want to talk about with your doctor.

Analgesia of various kinds is given as a shot in a muscle or in an IV in the vein. This kind of medication may help relieve pain, and your doctor may combine it with other medication to relieve anxiety or nausea. There are side effects that may include sleepiness, trouble concentrating, and nausea. Because these analgesics may cause breathing problems for the baby, they aren’t given right before birth.
Local anesthetic, such as a pudendal block, will numb the perineum before birth. It relieves pain around the vagina and rectum as the baby comes through the birth canal. It’s a very safe kind of anesthesia and side effects are rare. It’s given shortly before birth, so it won’t help relieve the pain of labor.
Regional anesthesia, such as an epidural and spinal blocks, will cause the lower half of your body to be numb. With an epidural, the medication is given around the covering (dura) of the spine, and takes effect almost immediately. An anesthesiologist will inject the medication and insert a catheter, which means the medication can be regulated and given throughout labor and delivery. Low doses are used to avoid side effects to mother and baby.

Although you probably won't feel pain, you may still feel pressure or be able to sense your contractions. Most women who have an epidural can deliver normally. If you have so much anesthesia that you can't feel the baby's head, it may be harder to push the baby out. Side effects may include the possibility of the mother's blood pressure dropping, which may then slow down the baby's heartbeat. Rare problems include having the covering of the spinal cord pierced, which will result in a severe headache that can last for a long time. Epidural blocks are also used to relieve pain during cesarean birth.
Spinal block is an injection in the lower back that will numb the lower half of your body. Unlike the epidural, however, it will only last an hour or two and is given only once during labor. It’s usually used for pain relief during birth or if forceps or vacuum extraction are used.
Combined spinal/epidural block is a technique that gives the quick pain relief of the spinal combined with the continuous relief of the epidural. These blocks are known as "walking epidurals" because there is less numbness and you can stand more easily than with either a spinal or an epidural block alone.
General anesthesia can be used for a cesarean or an emergency vaginal delivery. Most women today do not have general anesthesia for childbirth.