Local Anesthesia

Local anesthesia is the use of drugs to prevent pain in a small area of the body. The anesthetic drug is injected into the area around the nerves that carry feeling to the vagina, vulva, and perineum. Local anesthetics provide relief from pain in these areas. The drug also is used when an episiotomy needs to be done or when tissues need to be repaired after childbirth. When used to relieve pain during childbirth, the drug is given just before delivery.

Using Local Anesthesia During Labor

Local anesthesia is injected into a specific area to provide pain relief during labor. Local anesthesia methods include:

Epidurals – medication given through a tube placed in the lower back

pudendal blocks -medication used to relieve pain in the vagina, vulva, and perineum

spinal blocks – medication given as a single shot into the fluid around the spinal cord

It is also given near the end of birth for an episiotomy, to relieve the discomfort of the perineum stretching and also after birth to repair tears and episiotomies.

When used at the end of birth or after birth, medication such as procaine (Novocain), lidocaine (Dalcaine, Dilocaine, L-Caine, Nervocaine, Xylocaine), and tetracaine (Pontocaine) are injected into the skin, muscle, or cervix for the fast, temporary relief of pain in the perineal area.

Though rare, a local anesthesia may be injected into the perineum when the baby’s head position will not allow a pudendal block to be administered.  This will ease the pain of the perineum stretching, but will not relieve the discomfort of contractions during labor.

Are there any risks when using local anesthesia to relieve discomfort in the perineum?

Studies show there are no significant risks, except for rare allergic reactions. Some believe the injection may cause swelling of the perineal tissue and increase the likelihood of tearing if an episiotomy is not done. However, Kegel exercises can significantly strengthen the perineum.


American College of Obstetricians and Gynecologists: Medications for Pain Relief During Labor and Delivery

ACOG: Making Sense of Childbirth Pain Relief Options