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Abstract Pain during the first stage of labor results primarily from uterine contractions and dilation of the cervix. Pain is transmitted by visceral afferent nerve fibers that accompany the sympathetic nerves and enter the spinal cord at T10 to T12 and L1 segments. During the late first stage and second stage of labor, pain results from distension of the pelvic floor, vagina, and perineum. Pain is transmitted by somatic nerve fibers, which enter the spinal cord at the S2 to S4 segments. A variety of labor analgesia options are available including psychoprophylaxis, transcutaneous electrical nerve stimulation (TENS), systemic medication, inhalational technique, and neuroaxial blocks. In addition, other regional techniques such as caudal or paracervical block are used infrequently. |