Labor Analgesia With Large Babies

I have two children, both were quite large at birth. The first was 11 lbs. 1 oz. and I delivered with a spotty epidural (18 hrs and pitocin drip). The second was 10 lbs. 8 oz. and I delivered in 4 hours with Stadol. I have found neither drug to be particularly effective in allowing uterine contractions to continue unobstructed while blocking the actual pain of delivery and tearing, which I found pretty intense. Can you make any recommendations?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Dear Diane,

Usually epidurals do work for just the pain you describe but they must be "topped off". Some women wish to avoid epidurals however due to the fetal side effect potential and for all of the interventions that follow such anesthesia.

Nubain is a short acting, synthetic narcotic which gives mothers some relief and helps relax them. Vistaril will relax women also but must be given in large enough doses (100 mg).

Of all the analgesics for long labors, however, I would recommend intrathecal morphine or intrathecal narcotics, sometimes given with a local anesthestic. This is not available at all hospitals so you should check with your local maternity floor to see if this is possible. It provides excellent anesthesia with none of the fetal effects and the mother can usually be up walking. You may want to review other letters where we have discussed this.

I hope you have been tested for gestational diabetes which can result in the birth of large babies. I hope your next birth goes well and you can stay on top of the labor.

I wish you the best.
Peg

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