The majority of women who deliver a baby each year opt for pain relief. Many choose a walking or low-dose epidural, believing that they'll be able to pace the halls during their pain-free contractions. But that's not always the case. "A walking epidural is really a misnomer. The majority of women who have one aren't getting out of bed," says Linda Mayberry, R.N., Ph.D., associate professor of nursing at New York University. Below are the three most popular options for labor pain relief. All have the following drawbacks: The anesthesia may lower your blood pressure, which can slow the baby's heart rate; contractions may be slowed, in which case Pitocin (a synthetic version of the hormone oxytocin) may be used to stimulate them; increased monitoring such as blood pressure and fetal monitoring is required; and sometimes a bad headache may set in.

Epidural

Anesthesia, such as bupivacaine or lidocaine, is injected through a catheter into the space around the spine.The catheter remains in place, so additional doses can be given throughout labor.

Pros

• Pain is nearly eliminated, and you'll remain alert
• Relief is lasting because catheter remains in place
• Anesthesia does not enter the baby's bloodstream

Cons

• Anesthesia can take up to 20 minutes to kick in
• You won't be able to walk
• Since the lower body is numb, it may be difficult to push during delivery

Spinal block

With a spinal block, anesthesia is injected directly into the spinal cord fluid. Relief is fast, but wears off after a few hours. Since there is no catheter, additional doses aren't an option. Spinal blocks are frequently used late in labor.

Pros

• Relief is almost immediate and you'll remain alert
• Anesthesia doesn't enter the baby's bloodstream

Cons

• You can't walk
• Relief only lasts for an hour or two
• Numbness may cause difficulty pushing in delivery
• Rarely, an infection or nerve injury can result

Walking epidural

This option combines a narcotic like fentanyl (which dulls pain) with a lower dose of anesthesia (which blocks all sensation in one part of the body), leaving your legs less numb. Because of this, some women can move around and get out of bed. (Note: This isn't available at all hospitals.)

Pros

• Pain relief is very rapid
• Relief continues throughout labor since a catheter remains in place
• You may be able to walk around

Cons

• The narcotics can leave you groggy and the baby sleepy
• Rarely, an infection or nerve injury can result

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