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As an anesthesiologist, I have been caring for women during labor and delivery for 20 years. I specialize in relieving the pain of childbirth using the most effective and reliable means available—epidurals and spinals. In my experience, I've noticed that many mothers-to-be are concerned about the safety of these pain relief techniques. The thought of receiving an epidural, which involves inserting a needle into the lower back, can be very unsettling. The mere mention of the term "spinal" may cause even more fear, often compounded by having heard a frightening story about anesthesia. A woman's double-edged fear, of both labor pain and the techniques commonly used to treat it, can cause anxiety for months before delivery.

Women attending childbirth education classes, who are predominantly first-time mothers-to-be, report that some instructors put a negative spin on epidurals and spinals, dismissing them as "unnatural" or even harmful interventions. Social pressures may dissuade women from choosing an epidural or spinal if they feel that a request for pain relief will be interpreted as a sign of weakness. Women also refrain from asking for pain medication out of concern that it will harm their babies— an unnecessary fear, mixed with guilt.

Beyond these issues, I came to realize that the leading cause of misunderstandings about modern pain relief techniques is simply a lack of accurate and up-to-date information. Browsing through the books my wife read during her first pregnancy, I found that although many of them discussed a variety of ways to manage the pain of childbirth, none presented the full picture of epidurals and spinals, even though these methods are used by most women who give birth in the United States. Worse still, I found that some books were filled with erroneous information about these techniques.

In 1996, to better inform and educate patients about epidurals and spinals, I began offering a monthly seminar at New York University Medical Center, where I work and teach. The success of this program persuaded me to extend its reach by writing this book. Enjoy Your Labor is based on the questions that expectant mothers have asked me over the years. It describes epidural and spinal techniques in detail. It demystifies these procedures by explaining in easy-to-understand terms exactly what to expect. Once women have a thorough understanding of what's involved, I have found that they are much less anxious about receiving pain relief, and perhaps about the process of delivery itself.

In addition to presenting incomplete and inaccurate information about epidurals and spinals, however, there is something else missing from other books: not one describes the "new" approach to labor pain relief that I recommend. My philosophy is quite simple. It is based on common sense: if you choose to have the best pain relief possible for labor and delivery (an epidural and/or a spinal), you should receive it before severe pain begins, assuming it has been established that you are in labor. Unfortunately, most women today receive the epidural after their labor pain becomes unbearable. Although my approach seems obvious and logical, many people oppose it, perhaps because it is so radically different from the way childbirth pain has been handled for so long. After reading this book, you'll understand why it makes sense to get the epidural as soon as it is clear that you are truly in labor, and before the pain becomes intolerable.

I chose the title Enjoy Your Labor because that is what I tell my patients after I give them their epidural. You can enjoy your labor, by educating yourself about the types of pain relief you may choose, and by taking advantage of what modern medicine has to offer. After reading this book—well in advance of your due date—talk to your obstetrician or midwife about your concerns regarding labor pain relief and the available options. If you require additional information, contact an anesthesiologist at the hospital where you are planning to deliver your baby. To help you feel at ease about your upcoming childbirth, it makes sense to discuss the alternatives with the people who will be assisting you through labor and delivery.

This book is written from my perspective as an obstetric anesthesiologist practicing in a major teaching hospital where medical advances are introduced, and where my colleagues and I provide full-time coverage in the labor and delivery suite. At smaller facilities, anesthesiologists may serve obstetric patients on an as-needed basis: certain techniques described in this book may not be available at such places. Learn which options will be available to you by speaking with both your obstetric care provider and an anesthesiologist where you will be delivering long before labor commences.

A clear understanding of the process of labor pain relief will reduce your fears about your upcoming delivery. Empower yourself with knowledge so that you can make an informed choice. Furthermore, knowing what to expect in terms of pain management will help to focus your thoughts on the one that is most important: the anticipation of your new baby.

A sure way for women to expericence painless childbirth

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