IV Drugs


Systemic drugs that affect the entire body.

    Types: Analgesia

    • Fentanyl is commonly used.
    • Pain relief. It takes the edge off the pain but you still feel the peak of each contraction. 
    • Useful if you need a break or longer rest between contractions due to exhaustion, long or slow progressing labor.
    • Takes effect within a few minutes.
    • Last 1-2 hours per dosage.

    Types: Anesthesia

    • Typical drugs are in the 'caine family - Bupivicaine, Marcain, etc.
    • Blocks pain receptors. Takes away sensations, makes intense contractions seem very mild, more like early labor
    • Takes effect within a few minutes
    • Lasts 1-2 hours


    • Changes pain perception without loss of mobility

    Side effects / Potential risks

    • May slow labor if given too early
    • May lower mother's blood pressure and fetal heart rate
    • Dizziness, nausea, itchiness
    • Disorientation
    • Decreases endorphins so when pain comes back it may be more intense
    • Can cause drowsiness and slow reflexes in baby for a few days if given late in labor



    Regional drugs which, in this case, affects the abdomen and lower extremities

    Typical procedure

    • Administered when the cervix is 4-5 centimeters dilated and the mother is in 'active labor'
    • Mother’s back is cleaned/prepped with an antiseptic, and a local anesthetic is administered to numb the area
    • Mother sits or lays on her side, curled up
    • Needle is inserted between the vertebrae and the catheter is threaded through
    • The needle is then removed and the catheter is taped down
    • The drug administered via the catheter is usually a local anesthetic (bupivacaine, chloroprocaine or lidocaine) and may be combined with a narcotic (usually epinephrine, fentanyl, morphine or clonidine) to prolong the epidural's effect or to stabilize the mother's blood pressure
    • Administration and monitoring is done by an anesthesiologist, obstetrician/midwife, or nurse anesthetist
    • Drug takes effect 15-20 minutes after inserted, with redosing every 1-2 hours


    • Pain relief by blocking nerve impulses in the lower spine to decrease sensation in the lower half of the body
    • If anxiety is slowing down labor, the epidural may speed things up
    • Can transform exhaustion, irritability and fatigue, into relief, rest, comfort, focus and the strength to move forward, actively participating in the birth experience
    • Allows you to stay awake and actively participating during a cesarean section

    Side effects / Potential risks

    • The success depends mostly on the anesthesiologist's skill set
    • Reduction of muscle strength, balance, and reaction times
    • Decreased mobility - restriction to bed depending on type of epidural and dosage
    • Numbness may continue for several hours after birth, limiting mobility or requiring assistance with movement
    • No food or liquids - ice chips only -
    • Fever
    • Severe headache (1% of women)
    • Heart monitor to track mother's heart rate
    • Sudden drop in mother's blood pressure may require IV, medication, and/or oxygen
    • Routine blood pressure check to ensure baby is receiving adequate blood flow from mother 
    • Shivering, ringing in the ears, backache, nausea, difficulty urinating, severe headache (1% of women), soreness or permanent nerve damage a the needle insertion site
    • A urinary catheter (if labor is slow or if its the hospital policy) due to loss of feeling and control from waist down
    • Alternating sides while laying down and continuous monitoring of fetal heart rate
    • Interventions - forceps and vacuum (2-14 times more likely), episiotomy, or cesarean section (2-3 times more likely) - may be required should your baby become lethargic in utero, have difficulty getting into the proper birth position, experience respiratory depression, and/or show signs of decreased or unstable fetal heart rate
    • Slowed, weakened or ceased contractions will require a dosge of Pitocin to be administered which causes very intense, long and painful contractions
    • After birth, some babies struggle to latch on, causing breastfeeding difficulty


    • What combination and dosage of drugs will be used?
    • How could the medications used affect my baby?
    • Will I be able to get up and walk around?
    • What liquids and solids will I be able to consume, if any?
    • Does taking this medication start  a time limit on the duration of my labor progress?
    • What percentage of epidural births that you've attended have resulted in C-section or other interventions?