Anesthesia is injected during childbirth in three different places. These are local anesthesia, intravenous medicines, and epidural anesthesia. Let’s jump to find out more about this.

Where is local anesthesia injected during childbirth?

During a normal vaginal delivery, there is a possibility for the normal vaginal hole to be extended for the baby to come out. This process is called an episiotomy. According to statistics, as many as 20% of vaginal deliveries may require an episiotomy. To do this there is a small cut made in the vagina.

To achieve this in a pain-free situation there are two things that are done:

  • Local infiltration: The local anesthesia is injected around the vagina. I have included a picture of where local anesthesia is injected.


  • Pudendal nerve block: The local anesthesia is injected into the pudendal canal and this is where the pudendal nerve is. I have inserted a picture of a pudendal nerve block from a pin on pinterest.
Local anesthesia injected in the pudendal canal where pudendal nerve is

The pudendal nerve block provides quick pain relief in the areas of the perineum, vulva, and vagina. It is usually timed to be given during the second stage of labor (by the way, there are four stages of labor). This helps with pain relief as the baby is coming out of the vagina and helps with episiotomy pain.

What is the intravenous medicine option?

During childbirth, an intravenous line is always placed. This is because of the expected and unexpected need for medicine administration.

To achieve pain relief during childbirth, the following medicines may be used in combination with local anesthesia and epidural anesthesia:

Opioid medication – administered by the nurse

  • Fentanyl
  • Morphine
  • Meperidine (Pethidine)
  • Butorphanol
  • Nalbuphine

Patient-controlled analgesia: This is opioid medication administered by the patient themselves. The medicine dose and duration are set by the doctor.

These options are insufficient by themselves. They also carry the side effect of affecting the baby and making the newborn baby making more sleepy. Mothers can also have side effects like

  • Itching
  • Nausea
  • Vomiting
  • Constipation
  • Urinary retention
  • Respiratory depression

How is epidural anesthesia injected during childbirth?

Epidural anesthesia is the most common and preferred modality of anesthesia injected during childbirth.

To perform this, obtaining consent from the patient is the first step. The procedure happens this way:

  • You are made to turn to the side or sit up (preference based on the doctor and patient factors)
  • The epidural space is identified. This is done with the experience and feel of the spine. Sometimes an ultrasound may be used.
  • Local anesthesia is infiltrated into the skin. This is lidocaine
  • Then an epidural needle is injected into the space. A syringe filled with saline (my preference) or air is placed on the needle. The needle is gently pushed in until the epidural space is identified.
  • Following successful identification, an epidural catheter is placed there. This catheter is a thin plastic tubing (actually a PTFE material).
  • After the position is confirmed using a small dose of lidocaine as a local anesthetic, this catheter will be used to administer medication either continuously or continually to provide pain relief.
Epidural needle and catheter placed in the back during anesthesia childbirth

Is epidural anesthesia placed in all childbirth?

I cannot comment on what is the best anesthesia for childbirth. It depends on the patient and the place they are in. What is best for you will be clear after your doctor talks to you and examines you.

Epidural anesthesia is generally placed in many women if not all for the reasons I mentioned above. It is generally placed when the cervix is dilated 4-5 cms and the woman is in active labor. Occasionally it may be placed before or after.

Providing anesthesia is quite challenging for the anesthesia doctor as they must make sure the mother has pain relief without making her sleepy or the baby sleepy and be able to contract or push whenever she is asked to do so.

Click this to watch this as a video on YouTube


Check out other videos on general anesthesia and surgery:

How the Oscar Winner The Million Dollar Baby movie got a simple medical clip wrong

Here is a simple home remedy that can be used for nausea after anesthesia



VIDEO DISCLAIMER: All the views expressed in this video and other videos on the channel are personal opinions of the speakers and do not represent the views of the organizations either past or present they represent MEDICAL ADVICE DISCLAIMER: All content in this video and description including information, opinions, content, references, and links are for informational purposes ONLY. Accessing, viewing, reading, or otherwise using this content, or providing any medical information to the author does NOT create a physician-patient relationship. The information in this video is not intended nor implied to be a substitute for the services of a trained physician or health care professional, or otherwise to be a substitute for professional medical advice, diagnosis, or treatment. You should consult a licensed physician or appropriately credentialed health care worker or your own doctor/healthcare professional in all matters relating to your health or your child’s health or both. Never disregard professional medical advice or delay seeking it because of something you have seen or read in this video.





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