Anesthesia choices. The epidural really works best for pain management without exposing baby to medication. Many patients get by with IV pain meds like demerol (meperidine hydrochloride). There are a few docs that do a nerve block vaginally called a pudendal block that can help prior to delivery. There's also those that get by without anything. In these cases, a good support system or doula can be helpful. I personally like epidurals best.
Options. Options include not receiving any medications at all, some patients feel strongly that they wish to experience every aspect of the birth of their child. The most significant pain of labor is during the late stage as the baby passes the lower birth canal. Epidural catheters are highly effective for this and allow mothers to have very good pain control while being able to fully experience the birth.