By: Erinna Cooper, MSN, RNC-OB

You’re pregnant. Congratulations! As an expecting mother, you will be faced with many choices and decisions throughout the next nine months. One of the more important is your selection of pain management options for the birth of your baby.  While every woman will experience some degree of pain, it is up to you how you would like to manage it.

At Brattleboro Memorial Hospital (BMH), we provide a wide range of options for laboring women, including both non-medicated and pharmacologic options:

Non-Medicated Approaches

Labor Tubs and Showers: Water is a natural relaxant, easing involuntary muscle tension and lowering blood pressure, which increases your body’s production of pain relieving hormones. Warm water relaxes your pelvic floor and perineum, which will decrease your chance of tears during birth. Laboring in the tub or shower allows you to easily changed position, aiding the progress of labor.

Birthing Balls and Stools:  Similar to gym balls, birthing balls are designed to help your body develop various upright positions for easier labor.  During your labor, the ball will aid you to naturally sway and rock in rhythm with your contractions.  Similarly, birthing stools offer a wide range of natural positions for your laboring body – from squatting and kneeling to lying, standing, or rocking.

Lamaze and Hypnobirthing: Two prenatal education options offer an alternative view to labor and teach both the mother and her birthing partner the benefits of special breathing techniques, nutrition, body toning, exercise, meditation, and relaxation.  Learning how to respond to pain will allow you to take control of your labor and increase your comfort during that time.

Ambulation: Movement throughout labor will help your body to relax and naturally welcome the progression of your body towards birthing your baby. BMH staff encourages our patients to stay out of bed and move, as well as remain off the monitor when safely possible.

Pharmacologic Options

Fentanyl, Stadol, and Nubian: Opiate options offer fast-acting pain relief. These options help to relax the body and provide some relief of discomfort. Administered via IV or intramuscular depending on the medication and dose, opiates may be longer lasting throughout labor or short acting to assist with getting through the final stage of birth.  These medications can be given in intermittent doses at your request, depending on where you are in your labor progress, and at your provider’s discretion

Intrathecals and Epidurals: While both administered via an injection in the lumbar region of the back, intrathecals and epidurals differ in length of your labor. An intrathecal is used for a short period of time later in labor.  An epidural can be used for a long period of time and dosing can be controlled based on patient needs. Discuss with your provider your options

Anesthesia: Our knowledgeable team of anesthesiologists has almost ninety years of combined experience and is available 24/7. While the medication is administered in a variety of forms, the effect of it will provide you with pain relief and relaxation.

A New Option

Nitrous Oxide: Commonly known as laughing gas, nitrous oxide is a new option we’ll be able to offer laboring mothers by the end of 2017.  With years of research and hundreds of studies behind it, nitrous oxide is considered both safe and effective for pain management during labor. This medication will not completely eliminate pain, instead it relaxes your body and changes your perception of the pain you experience. This method is self-administered – you choose how much you need to use and when you would like to cease use. The effects of the medication stop within five minutes of cessation.  As with any prescribed medication, nitrous oxide may cause mild side effects for you.  Discuss with your provider if this could be an option for you.

While you may plan for a certain method of childbirth, it is helpful to understand that once your labor begins, you may need to change course.  Discuss with your care provider the possible paths your labor may take you – it is perfectly normal to change your plan – the welfare of you and your baby are the first priority.  At BMH, we are committed to the care, compassion, and safety of both you and your baby.

Erinna Cooper, MSN, RNC-OB is the Director of the Birthing Center for Brattleboro Memorial Hospital. Located at 17 Belmont Avenue, Brattleboro, VT, the Birthing Center provides a wide range of childbirth options for each patient’s unique needs, from prenatal care and labor to education and support groups.  It’s your bump, your baby, your way.  To learn more or schedule a visit, call (802) 257-8226 or visit