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Local injections of a numbing medication may be used to relieve a small area of pain, typically around the vagina, if you require an episiotomy to extend the vaginal opening or if stitches are needed to repair any damage. This type of anesthesia cannot be used to relieve the pain from contractions during labor.
A pudendal block is another type of local anesthesia. It involves injecting a numbing medication into the vaginal wall shortly before delivery to block pain signals from the vagina and area around the vaginal opening. It usually works within 10 minutes and lasts for up to an hour.
Narcotics, or opioids, are drugs that decrease our perception of pain. They may be given intravenously or as an intramuscular injection during labor. They may lead to nausea or sleepiness, and they do not completely eliminate pain. Although narcotics have been shown to be safe in labor, they may cause a temporary depression in breathing for both mother and baby.
Nitrous oxide is an odorless, tasteless, inhaled gas that is given using a hand-held face mask. It is not generally used in labor in the US but is sometimes used in the United Kingdom and Canada. It has little effect on the baby. Nitrous oxide does not eliminate pain but changes the way the pain is perceived.
REFERENCE: MedscapeReference.com. Labor and Delivery, Analgesia, Regional and Local.