When to Use Medication
In a Planned Natural Childbirth
At some points in some labors women may be faced with the recommendation to use medication to assist with labor. For the mother who planned a natural birth, this can be frustrating and disappointing. It can also be somewhat confusing. How do you know if it is time to use medication?
Unfortunately there are no hard and fast rules for when to use a medication. You will find there are a variety of pharmacological options for labor that do anything from start or speed up labor to decrease the pain you feel. Most women will get to a point in labor where they give up and feel like they cannot give birth naturally. For that reason, it is wise to understand the normal process of labor and be aware of the difference between the normal feeling of "giving up" and a true need for medical assistance. If you find yourself in labor not knowing what to choose, the following considerations may help you decide how to proceed.
Before deciding one way or the other make sure you understand what the purpose is for the medication. What do you hope will happen if you use it? Then find out if there are other ways you could try to achieve the desired goal. Find out what the next step would be if the medication is not effective, and find out what you need to do to make the use of the medication the most effective. You may find it takes time to assess the situation and make an informed decision, and that is usually OK. Most of the time there is not a problem putting off a medication for an hour or two while you wait to see if something else will be effective. Take the time you need to explore your options.
Weigh the risks and the benefits. If the goal is to lessen pain you may feel trying different positions has a better ratio of risk to benefit. However if the goal is to get some sleep so your body can continue with a non-surgical birth, you may feel the risks of not using the medication and not sleeping are higher than the risks of using a small dose of medicine.
How does the timing of the labor affect your desire to use a medication? You may find it more appropriate to use a medication if your labor has lasted longer than 18 hours than you did when you were two hours into your labor. Some medications should not be used within two hours of birth, so be sure to consider how far you have progressed before making a decision.
If the medication being considered is for pain, pay attention to how you are managing labor. It is not realistic to expect comfort measures to keep you relaxed and pain free during contractions (even though some women experience labors with little or no pain). If the comfort measures allow you to relax and not be overwhelmed between contractions you are actually doing very well. A good technique is to give yourself half an hour to an hour to try different techniques and positions to see if something is more comfortable before you commit to using a medication. You may find something that works much better for you, or you may find yourself pushing before the hour is through.
Regardless of the decision you have made, understand that you are making the best decision you can with the information you have. It is not fair to second guess yourself after the labor when you have more information. If after labor you decide you would have handled the situation differently that is ok, and given all the information you now have you will probably make a better decision if the situation ever happens again.