As labor progresses—into the transitional phase
As labor continues, your vital signs (pulse, respiration, and blood pressure) will be taken more often. Your health care provider will also continue to monitor the changes in position of the baby, your temperature, and the length and strength of your contractions. Your contractions will probably be lasting longer now.

How dilated (open) your cervix is will be measured by a vaginal examination. The cervix will dilate more and more with each contraction. If you ask your health care provider how your labor is progressing, the answer will be in terms of dilation of the cervix. When the cervix is almost fully dilated—open 10 cm (about 4 in) wide—you have completed the first stage of labor and are moving into the transitional phase.

The transitional phase may be a period of discouragement. You may feel that you cannot endure without some pain control. You will experience an intensifying urge to bear down, but will be asked not to do so until your health care professional is sure you are fully dilated.

Fortunately, this phase usually lasts only an hour or less.

Management of pain during labor and delivery
Most likely, you will not get pain relief unless you request it or are obviously in distress. You may be able handle the pain of labor by using the relaxation, breathing, and other techniques learned during childbirth classes.

One of the most common methods of pain relief is the epidural block. The epidural, which is administered by injection into a tube that has been placed in your back, provides effective pain relief. However, if it is done early in labor, it may increase the need for a cesarean section—the removal of the infant by way of abdominal surgery rather than by the usual vaginal delivery.

Spinal anesthesia is usually not ordered until just before delivery, or unless the doctor decides that a surgical delivery is necessary, because it may interfere with your ability to push the baby out of your body.

You and your doctor may choose a form of local anesthesia—a less potent alternative—that will relieve pain without as great a chance of leading to surgical delivery. For the delivery itself, you and your doctor may decide on the use of a local anesthesia that will control the discomfort without interfering with your ability to deliver naturally.

Consult your health care professional if you have any questions about pain management during labor and delivery.