Pain Management and Anesthesiology for Labor and Fetal Surgery

If your baby has a prenatal (before birth) diagnosis, delivery and fetal surgery can be stressful. Our anesthesiology team is here to help keep you and your baby comfortable, calm and safe.

Colorado Fetal Care Center anesthesiologists are physicians with specialized training in labor and delivery, as well as fetal surgery. We have a dedicated anesthesiologist on-site 24/7 who specializes in caring for you and your baby. An anesthesiologist will meet with you before your scheduled delivery or fetal procedure to tailor a plan to your needs, medical history and procedure.

What anesthesiology services do we offer?

If you’re having prenatal surgery, delivering your baby or both at our Colorado Fetal Care Center, our anesthesiology team will create a care plan just for you. We offer various services described below to make your experience more comfortable. Our anesthesiologists will work with you to understand your goals and recommend a pain management option that best suits your needs.

Every birth is different, and we will discuss all available options so you can make an informed decision for your pain management.

Our anesthesiology services include:

• Epidurals for labor pain management
• Spinal anesthesia (numbing medicine) or general anesthesia (being asleep) for cesarean delivery
• Sedation (reducing pain and stress), spinal anesthesia (numbing medicine) or general anesthesia for fetal surgery

If you have questions about a specific anesthesiology service, please call our Center at 720-777-4463.

Labor and delivery pain management

Labor is a unique experience for each mom. We support you and your pain management goals, so you have the most comfortable and stress-free delivery possible. You have several options for labor pain management:

• No pain medicine or non-medicated delivery
• Intravenous (IV) pain medicine
• Epidural for vaginal delivery
• Spinal anesthesia for cesarean delivery

Vaginal delivery pain management options

We work with you to find the best option to meet your preferences and make you feel comfortable. Most moms choose an epidural, as it provides the most effective pain relief and still allows you to move your limbs and feel the pressure necessary to deliver your baby. We use an epidural technique, known as a combined spinal epidural, that provides faster pain relief and reduces the chances that we will have to replace the epidural. This is the most popular pain relief option in our Center. However, the choice is always up to you.

We also offer these pain management options for vaginal delivery:

• Non-medicated delivery: For moms who don’t want medication, there are other methods that provide you relief, such as aromatherapy, heating pads and relaxing music.
• IV Medications: Low-dose narcotics provide you general pain relief and are a safe option for you and your baby. The medication is not specific to where you are feeling the most pain and doesn’t reduce pain as much as an epidural.

What can I expect from an epidural for vaginal delivery?

Our anesthesiology team will discuss your individualized care plan with you so you know what to expect before, during and after delivery.

Epidural placement is a fairly quick procedure. Here’s what to expect:

• You will sit (or you can lie on your side) as our team helps you curve your back into the correct position and cleans your back with soap.
• We place numbing medicine on the skin on your lower back to make the procedure comfortable. Then we place the epidural needle into your back. This will only feel like pressure.
• We place fast acting medicine through the epidural needle for pain relief.
• We pass a catheter through the epidural needle, then remove the needle and secure the catheter to your back with tape. The catheter allows us to deliver medication for as long as you need it during labor.
• You can lie in any position in bed with the catheter in place.
• Throughout your labor, our anesthesiologists will talk with you about how you feel, monitor your vital signs and adjust as needed. You may experience the following effects:
  • Your legs may feel heavy and numb, which is normal. If your legs feel too heavy to lift, your anesthesiologist adjusts your medication.
  • The medicine may lower your blood pressure. Our team monitors your blood pressure the entire time and adjusts medication as needed.
  • Epidurals sometimes cause itchiness that passes quickly.
  • Epidurals sometimes work better in covering some areas than others. If this happens, we’ll adjust or replace the epidural so you are comfortable.
  • Rarely, moms experience headaches the day after an epidural, but we have ways to treat this should it occur.
  • Infection or nerve injury is very, very rare.

What are the advantages of an epidural?

• Pain relief during contractions and delivery
• No sleepy or groggy feeling during or after delivery
• No pain medicine affects your baby, unlike intravenous or oral medicine
• It can provide medication in the event of an assisted (forceps) or cesarean delivery

What are some misconceptions about epidurals?

Many expecting moms have concerns and questions about epidurals, but not all are accurate:

• You don’t need a certain cervical dilation or time in labor to have an epidural.
• The medicine given through the epidural does not have any significant effect on your baby.
• Epidurals do not increase your chance of having a cesarean delivery.
• Epidurals do not increase the amount of time you are in labor.
• Women who have an epidural do not have more back pain after birth than women who do not have an epidural.
• You can still breastfeed effectively if you have an epidural.

Cesarean delivery pain management options

A cesarean delivery might not be what you planned, but our team will make sure you are comfortable. Nearly all our moms having cesarean deliveries choose spinal anesthesia (known as a spinal) or use their labor epidural in the rare instance where mom wanted a vaginal delivery, but a cesarean delivery became medically necessary during labor. A spinal allows you to stay awake and aware of the birth of your child or children.

What can I expect from spinal anesthesia for a cesarean delivery?

The goal of a spinal is to reduce pain from your mid-ribcage down while keeping you awake and alert. Our care team makes a plan with you and answers any questions you have.

Placing your spinal is a fairly quick procedure and follows these steps:

• You will sit (or lie on your side) as our team helps you curve your back into the correct position and cleans your back with soap.
• We place numbing medicine on the skin on your lower back to make the procedure comfortable.
• Then we place a very small spinal needle in your back. This sometimes causes a “funny bone” feeling in your back or down one leg. This feeling passes quickly.
• After giving you the spinal medicine, we remove the needle and nothing remains in your back.
• The medicine will make you numb from your chest to your toes so you are completely comfortable for the cesarean delivery but will not affect your breathing or the ability to move your arms freely.

The medicine lasts for several hours before wearing off. It may be a few hours after your cesarean delivery before you can walk.

As with an epidural, the spinal anesthesia may cause your blood pressure to drop, but we monitor you and provide medication to prevent this from happening. Rarely, a spinal may cause a headache, which we will treat. In extremely rare cases, a spinal may cause nerve injury or infection.

What are some misconceptions about a spinal?

Here are some facts to clear up common concerns and questions about having a spinal:

• The medicine given through the spinal needle does not affect your baby.
• Patients that have a spinal do not have more back pain postpartum than women who did not have a spinal.
• You can still breastfeed if you have a spinal.

How do we reduce pain after a cesarean delivery?

Our anesthesiology team also helps reduce your pain after delivery so you can enjoy time with your new baby.

• The medicine in a spinal can provide pain relief for up to 24 hours after your cesarean delivery.
• We schedule non-narcotic pain medicine around the clock as you need it.
• We place a special catheter under your incision at the end of your cesarean. This catheter provides numbing medicine for 2 days and can reduce the amount of pain medicine needed by almost 30%. Your nurse will painlessly remove this catheter after 2 days.

Pain management and anesthesia for fetal surgery and procedures

At the Colorado Fetal Care Center, we provide minimally invasive surgical options when appropriate to treat a baby’s condition before birth. Our anesthesiology team is a vital part of making surgery comfortable for you while keeping you and your baby safe. We will explain your individual plan with you and let you know what to expect for your procedure.

We typically provide two options for pain management for fetal procedures and they can be used together:

• Spinal anesthesia (known as a spinal)
• Intravenous sedation

Spinal anesthesia for fetal surgery

A spinal will keep you numb and comfortable for the entire procedure.

Placing your spinal is a fairly quick procedure and follows these steps:

• You will sit (lie on your side) as our team helps you curve your back into the correct position and cleans your back with soap.
• We place numbing medicine on the skin on your lower back to make the procedure comfortable.
• Then we place a very small spinal needle in your back. This sometimes causes a “funny bone” feeling in your back or down one leg. This feeling passes quickly.
• After giving you the spinal medicine, we remove the needle, and nothing remains in your back.
• The medicine will make you numb from your chest to your toes, so you are completely comfortable for the procedure.

We can also combine a spinal with sedation, which is explained below.

Intravenous sedation for fetal surgery

For certain surgeries and conditions, it may be best for you to sleep through a procedure with the help of medicine from an IV directly to a vein. Our anesthesiologists know when to recommend this option, and we’ll discuss whether this is a good choice for you.

Medicine we use for sedation is safe for you and your baby. During your surgery, our team monitors your blood pressure, breathing and heart rate to make sure you’re safe.

We also place numbing medicine on your stomach before surgery, so you feel little or no discomfort when you wake up. When the procedure is complete, we stop the medicine and allow the sleepiness to wear off while you recover comfortably in your room.

Why choose Children’s Colorado for anesthesiology services

Having a prenatal procedure or giving birth to a baby with a prenatal condition can be stressful, and you want to feel as comfortable as possible. Our anesthesiology team is here to put you at ease.

We offer an incredibly experienced and specialized anesthesiology team. Our team has advanced training in caring for both mom and baby, and we’re here 24/7.

Our anesthesiologists care only for moms in our fetal care center, so they’re fully dedicated to you. The anesthesiology care we provide requires precise treatment and medicine, which is why we only have maternal and fetal experts caring for you and your baby.

You’ll meet with your anesthesiologist before your delivery or surgery so you can discuss your needs, ask questions and create a care plan just for you. You’ll have the same anesthesiologist throughout your care, and they’ll check in with you after your procedure or delivery to make sure you and your baby are doing well.

We tailor our medicine to your needs and use as little medication as necessary to keep you and your baby comfortable. Only our level of experience and expertise makes that possible.