Abstract
Labor is painful and the majority of women rate the pain as severe. Melzack observed that labor pain was rated as more painful than cancer pain.
Labor pain itself has no direct effect on the fetus, because there is no direct neural connection from the mother to the fetus. However, labor pain can influence multiple factors that, in turn, may influence maternal hypertension, hyperventilation and uteroplacental perfusion. Uterine artery vasoconstriction, caused by maternal catecholamine release, may decrease oxygen supply to the fetus.
These effects are well tolerated in normal circumstances and are effectively blocked by epidural analgesia. Epidural analgesia may be especially important to fetal well-being when these effects of labor pain impinge on situations of limited uteroplacental reserve.
Although the epidural analgesia does have some side effects and complications, it can provide beneficial effects for the fetus and newborn as long as the side effects and complications of epidural analgesia are prevented or effectively treated.
