One innovation is the patient-controlled epidural, in which you regulate the amount of medication delivered by pushing a button. The needle goes through the dura directly into the spinal canal. Most women feel numb from the waist down, which can affect their ability to push. Spinals are usually given as close to delivery as possible, because they usually wear off after a couple of hours. And since predicting delivery time is never exact, the drug may wear off before the baby is born.
Side effects can include itching, nausea, vomiting, and shaking.
This allows for more pain relief with an epidural if the spinal loses its effectiveness before the baby is delivered. You also don't lose the ability to move. As epidurals have become more widely available, narcotics such as Demerol and Nubain are now given as primary labor-pain relief only if there's a risk of infection or you're extremely squeamish about needles going into your back. The patient-controlled pump allows you to increase the medication as needed and moderate these extremes. More important, though, the narcotic enters your bloodstream directly, so more of it reaches the baby, whose short-term side effects may include drowsiness and difficulty breathing.