In plain words
The pudendal nerve is a large nerve that runs through the pelvis and carries feeling from the , the vagina, and the area around the anus. During the , when the baby moves down and the perineum stretches, pain can come partly from this nerve. The pain is sharper and easier to locate than the deep pain of the first stage. Some numbing options, such as a pudendal block, work by numbing this nerve. Pressure on the nerve during birth can also cause temporary numbness or tingling afterward. Most numbness fades over weeks. Tell your provider about numbness, weakness, or pain in the pelvis that does not improve, so it can be checked.
The deeper version
The pudendal nerve arises from the sacral plexus, with fibers from S2 to S4, and supplies the perineum, external genitalia, and . Second-stage labor pain includes a somatic component from perineal and vaginal stretch conveyed through this nerve, which is sharper and better localized than visceral first-stage pain (Standring, Gray's Anatomy, 42nd edition, 2020). Pudendal nerve block is a regional technique used for operative and some vaginal deliveries, as summarized in ACOG Practice Bulletin 209 (2019) on obstetric analgesia and anesthesia. Nerve injury from or instrumental birth is a recognized cause of pelvic floor dysfunction and urinary symptoms. The main controversy concerns the incidence of persistent pudendal neuropathy after vaginal birth and how to measure it.
Where it comes up
- Pain options: from breathing to epiduralGetting Ready for Birth
- Peeing after birth and leakingPostpartum: Your Body
- Your pelvic floor after birthPostpartum: Your Body
- Pushing and positions for birthGetting Ready for Birth
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Sources
- Standring S (ed.) — Gray's Anatomy: The Anatomical Basis of Clinical Practice, 42nd edition (2020)
- American College of Obstetricians and Gynecologists — Practice Bulletin 209: Obstetric Analgesia and Anesthesia (2019)