Expert: Catherine Beier MS CBE - 8/16/2009

Question
I have been researching pain relief for childbirth, and have had someone tell me that during childbirth, they only took oral pain medication that took the "edge" off the pain. I have tried to research this, but only seem to find medications that are given as an injection or through the IV for pain - and all those seem to cross into the placenta and can affect baby.
THe oral drugs I have heard off, are mostly sedatives, but not pain relief.
Are there any safe drugs for pain relief that are taken orally during labor and birth? What are the options?
Thanks so much!

Answer
Jys,


Typically, medications would not be given orally for childbirth.  You are correct that it could have been a sedative, or narcotic given orally.  She might have received Tylenol with codeine, or some other such medication.  Medications given orally would also enter the bloodstream and cross the placenta, reaching the baby.



There really are no safe options to take orally.   No definitive studies have been conducted to study pain medications for use in pregnancy and childbirth.  Anything given by mouth or injection will breakdown and cross the placenta.  


This is also true of medications given via epidural.  They breakdown and cross cell membranes by diffusion, thus entering the baby's bloodstream.  However, epidural medications take the longest to cross to the baby, as compared to oral or iv medications.  Of the three methods, iv medications reach the baby the fastest in the highest doses.



Best,
Catherine