What is a safe pain-management option for a client who is dilated to 10 cm and pushing?

A pudendal block is a safe pain-management option for a client who is fully dilated and actively pushing during labor because it provides localized analgesia to the perineal area. This form of regional anesthesia is administered through injections into the pudendal nerve, which helps alleviate pain during the second stage of labor when the baby is being delivered.

At this stage, the client is experiencing intense pressure and pain in the perineum, and a pudendal block effectively numbs this area without affecting the overall progress of labor or the ability to push. It allows the mother to maintain sensation in the uterus and the ability to feel contractions while reducing pain, optimizing her capacity to participate actively in the delivery process.

Other options, while they may have their uses in different stages of labor or circumstances, are less appropriate here. Intravenous opioids may provide systemic pain relief, but they can lead to increased sedation and potential respiratory depression for both the mother and the newborn during delivery. Epidural analgesia, while effective for pain control earlier in labor, can result in complications such as delayed pushing and a higher likelihood of instrumental delivery. Non-pharmacological techniques may also be helpful but usually offer limited relief for the intense pain associated with pushing and are not as