Local Pain Relief with Lidocaine Injections and Your Birth Plan

By: Aunt Doula (11/27/2022)

During labor and delivery, there may be some situations that require a localized numbing prior to a procedure that may cause pain such as an episiotomy, manual removal of the placenta, or prior to an epidural placement. While most hospitals do not provide local anesthetic for most procedures as it may just add another poke to a quick procedure, it is an option open to you that you can request. Other possibilities include a numbing gel for IV placement if you have a fear of needles.

Local anesthetic is usually provided by injection with a medication called lidocaine and it is the same medication you may have experienced in the dental office for local numbing during a cavity filling. Lidocaine is used frequently across many areas of medicine and is relatively safe. It is possible that the lidocaine injection may contain epinephrine in a small dose which is just something to be aware of, not necessarily concerned about. This may cause a small increase in heart rate or make you feel anxious temporarily.

Gel that is applied to the skin usually is lidocaine suspended in a gel or cream and it is absorbed through the skin to provide a temporary local numbing sensation, so you do not feel a needle insertion as intensely. If you want to have this option available to you, request it at the time you are admitted.

If you have an episiotomy or a natural tear during birth and you have not received any other pain relief such as an epidural or gas & air, you may find the stitching to be very uncomfortable and want to request a numbing shot to help relieve the discomfort. This is your right, and you do not have to endure the repair! There is no prize for suffering – don’t be afraid to ask for relief.

In rare circumstances, you may have issues with the delivery of the placenta and require a manual removal of the placenta and membranes. This can be extremely painful and if it is not an emergency you can ask for pain relief prior to the removal procedure. You can also request that the removal be done as a surgical procedure known as a dilation and curettage instead of an in-room manual removal. This does require time away from your newborn, however the outcome may be more desirable and create less issues over time. This is a situation to be aware of described and is a part of choosing expectant or active management of the third stage of delivery. This local pain relief known as a paracervical block (numbing of the cervix and surrounding nerves) may be combined with a global anesthetic such as a narcotic through the IV to help you remain relaxed and able to withstand the procedure.

Local anesthetics are of varying use and frequency depending on the hospital policies and the provider who is administering care. It is important that you are aware of the options open to you even if they aren’t suggested immediately by your provider.