This page is a list of different medications that can be used in childbirth.
Systemic medications are listed here with their generic (chemical) names first and their brand names in parentheses. Effects and side effects vary, depending on the drug used, total dosage, timing, fetal condition, and the mother's individual response.
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Systemic Medications |
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| Type | Drugs used
(listed alphabeticaly) |
Benefits and/or purposes | Possible risks and/or disadvantages | Additional precautions/procedures/interventions to ensure safety | Notes |
| Sedatives and Hypnotics |
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Sedatives (which reduce anxiety, irritability, and excitement( or hypnotics (which induce rest, relaxation, or sleep) are administered only in early labor. Sedatives are smaller doses and hypnotics are larger doses of the same drugs. They may be used to give the mother a rest by decreasing contractions in a slow, painful pre-labor. | To mom: Hypnotic
doses may cause dizziness and disorientation and can prolong labor by
impairing uterine activity To baby: Barbiturates may accumulate in fetal tissue and cause respirator depression (decreased breathing) decreased responsiveness, and impaired sucking ability in the newborn. |
Should be
discontinued before active labor to reduce effects on newborn Oxygen and resuscitation equipment on hand if baby is born soon after barbiturates are given
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These are rarely used today because of undesirable side effects |
| Tranquilizers | Phenothiazines:
Benzodiazepines:
Other:
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Tranquilizers are
used to reduce tension, apprehension, and anxiety. If used in labor, the
dosage is timed to wear off before birth. The phenothiazines and
hydroxyzine are also used to reduce nausea and vomiting. They are sometimes
combined with narcotics to increase the effects of lower doses of narcotics. The benzodiazepines are sometimes given after cesarean birth to reduce anxiety during the repair. Some anesthesiologists give the benzodiazepines routinely |
To mom: Tranquilizers
may cause drowsiness, dizziness, blurred vision, confusion, dry mouth, and
changes in blood pressure and heart rate. When given with barbiturates or
narcotics, tranquilizers may increase their sedative and depressant
effects. Versed causes amnesia of events of birth and first contacts with
baby. To baby: Use of phenothiazines near term can inhibit newborn reflexes and cause jaundice. Benzodiazepines in labor cause fetal heart rate alterations, the "floppy infant" syndrome (poor muscle tone, sleepiness, and sucking difficulties), and a drop in body temperature. |
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Because Versed causes loss of memory, many women ask that it not be given because they want to remember their first hours with their baby. |
| Inhalation Analgesia | Nitrous Oxide (Entonox) | nitrous oxide rapidly
reduces pain awareness and in low concentration may be used during normal
labor. The mother, using a hand-held mask, administers the drug as needed. In higher concentrations, it is a general anesthetic and causes loss of consciousness |
Reduces mother's ability to use upright positions and to push effectively |
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I have not heard of this being used in the USA |
| Narcotic or narcotic-like analgesics |
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Narcotic analgesics, usually given during active labor, reduce pain awareness and promote relaxation between contractions. Some may indirectly speed a labor that has been slowed by tension and stress. Large doses of narcotics (especially morphine) are sometimes used in a prolonged pre-labor in hopes of stopping contractions and giving the mother a rest. They may also be used in post partum. Stadol and ubain are combination drugs - a narcotic plus a narcotic antagonist which reduces some of the narcotic's undesirable side effects. | To mom: Narcotic
analgesics may cause drowsiness, hallucinations, dizziness, euphoria,
respiratory depression, nausea, vomiting, and slowing of digestion. They
may lower blood pressure. They often interfere with mental activities and
the use of self-help comfort measures. Narcotics may temporarily slow labor
progress, especially if the medication is given before the active phase of
labor To baby: Narcotic analgesics may make the fetal heart rate readings appear abnormal, depress the newborn's respiration, and alter the infant's behavioral responses (for example breastfeeding) for several days or weeks |
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These are given intravenously, either by direct injection or injection into an intravenous line. Sometimes, a patient-controlled analgesia (PCA) device is used in labor, but more often after a cesarean. The woman presses a button when she needs medication, causing release of the narcotic into her IV |
| Narcotic Antagonists | Naloxone (Narcan) | Narcotic antagonists reduce narcotic effects such as hallucinations, respiratory depression, sedation and hypotension (low blood pressure). Narcan is given by injection to the laboring woman if there is narcotic toxicity, or to the newborn when there are respiratory problems caused by narcotics. | To mom and baby: Abrupt reversal of narc0tic depression may result in rapid heart rate, increased blood pressure, nausea, vomiting, sweating, trembling, and the return of pain awareness to the mother. The effects of narcotics may return if the narcotic antagonist wears off before the narcotic |
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