local anaesthetic?

[CorasMama]

I'm not having a baby again for at least 2 years, but something has been on my mind lately.

I remember with dd's birth, I was able to handle everything except about 10-15 minutes of the pain in my perenium/"ring of fire" area. I asked for a shot of novocaine (I get proactive and creative in crisis mode, which this was for me, as I had had no intention of having natural childbirth, but I went through transition in the car and arrived @ the hospital @ 9.5 cm). The nurses said they'd never heard of such a thing, and thus weren't prepared for this request. I felt like I was being split in two, though I didn't tear, just "skidmarks". I felt like I really could have done it and handled it just fine, if not for that one part. It inspired me that I could have natural childbirth next time.

Obviously, I want my next birth to be mostly a natural one (I have herpes, so I must have some sort of professional looking in on me), at either a hospital or birth center. But is it possible to have a little local shot right then, when it feels like I'm being ripped in two?

[SublimeBirthGirl]

I've seen a woman given lidocaine during crowning. You know that feeling that sensation is probably why you didn't tear though, right? The "ring of fire" is a direct message from your body telling you how to push to avoid damaging yourself. Another thing to consider, if it's important to you, is tat "local" is a kind of misnomer, and will still reach the baby. I have also heard that the local is pretty ineffective. I know that the one I got for stitches with my 1st was useless.

[ellebelle]

I have read that a local anesthetic given during crowning can cause swelling and increase the risk of tearing.

I teach my students in my childbirth classes that the "ring of fire" is nature's gift to help you prevent tearing. The pain signals encourage you to hold back from pushing to give the tissues time to stretch.

Here are a couple tips to help make that time more manageable:
1. prenatal perineal massage. I am not sold on the science that it will prevent tearing, but I do think it can help prepare a mom for the sensation of crowning and help her learn to relax through it.
2. choose a pushing position that reduces pressure such as on all fours or side-lying.
3. compresses
4. waterbirth (I personally recommend it - my last baby actually felt good coming out, LOL!)

Good luck to you.
Ellen

[CEG]

I think Lidocaine is what is usually given as a local for stitching and injected just prior to an episiotomy being cut. It might be effective but like a PP said, it causes swelling. Just watching someone being injected with it you can see their skin balloon up- I think that would open you up for some major tearing. I had lidocaine during repair for tears and can attest that it wasn't super effective, I could feel a lot.

There is something called a pudendal or saddle block you could look into. IMO it is pretty invasive but it would probably provide more pain relief with less swelling.

[Sileree]

Well I wouldn't advise numbing yourself, but if you are dead-set on it, I found this on the gentle birth archives:

"The topical lidocaine can have the effect of decreasing the burning sensation that accompanies crowning enough to help some women who are panicking have a more controlled birth, perhaps avoiding a tear or epis. It doesn't cause swelling the way injected lidocaine does which I believe contributes to potential problems with tearing. I have used topical lidocaine on myself and didn't feel that it caused the deep numbing of sensation that injected lidocaine causes."

"I agree. I use the gel when someone needs a diversion from the pain. I don't want to interfere if things are going well. I prefer oil, or a neat liquid called "Slippery Stuff". Also checked with a pharmacist. He said Americaine has more numbing effect than Lanocaine. I can't even find the other gel others have mentioned. And now I have forgotten the name!!"

[Carolinamidwife]

I have read that a local anesthetic given during crowning can cause swelling and increase the risk of tearing.

Yeah, that.

But also... you will probably not experience such a prolonged period of crowing with a second baby. If you go with a midwife they can offer you all sorts of soothing options for that part of the birth, from lubricating the baby's head to hot compresses (doctors usually won't do this) and you will have control over what position you give birth in as well as the freedom to do your own perineal support.