Pain relief options in labour
Giving birth can be painful and it is a good idea to know what your options are to help you cope during labour.
Your midwife will give you information about the pain relief options which are available to you and you may want to record your wishes in your birth plan. However, it is a good idea to keep an open mind as you don’t know how you will feel when you are actually in labour.
Our online antenatal class on Natural Labour and Birth includes information about pain relief, hypnobirthing and ways you can cope with your contractions while you are still at home. Finding out more about what happens during labour and birth will also help you stay calm as you will know what to expect.
Ways of managing the pain yourself
There are a number of things you can do yourself to manage your pain. Breathing exercises can help you get through contractions, especially in the early stages of labour. You may also want to try hypnobirthing or aromatherapy to help manage the pain.
Staying active can also help so try walking around, rocking backwards and forwards and changing positions. Many women find kneeling or using a birthing ball helps.
You may want to have a bath or you could ask your partner to massage you. But don’t worry if you don’t want to do these things, listen to your body and follow your instincts.
You can take paracetamol to manage the pain at home but make a note of when you take it so you don’t end up taking more than the recommended dose.
You can buy or hire a TENS machine to use during your labour or your hospital may have one you can use while you are there. It is most effective during the early stages of labour, especially if you are experiencing lower back pain.
TENS stands for transcutaneous electrical nerve stimulation and it works by passing small amounts of electrical current into your body to trigger the release of endorphins. These work as natural painkillers and it will reduce the pain signals that your spinal cord sends to your brain.
When you use a TENS machine, you will tape electrodes to your back. These electrodes are connected to a battery-powered stimulator by wires and you will still be able to move around. There are no known side effects but it will be unlikely to do much to help you manage your pain once you reach the second stage of labour. For a great discount on Baby Care Tens Elle 2 follow the link.
Gas and air
One of the most popular pain relief options in labour is gas and air, also known as Entonox. When you have gas and air, you will breathe in a mixture of oxygen and nitrous oxide through a mouthpiece or mask.
It will not take away the pain completely, but it will make it more bearable and you are in control of when you breathe it in. The effect of the gas and air takes around 20 seconds to kick in so you should start breathing it in as soon as you feel a contraction building. You can then take a break in between contractions.
Gas and air is very safe for you and your baby but some women don’t like the sensation and may even feel nauseous or dizzy. One big advantage is that if you don’t like the way it affects you, you can simply stop using it and it will wear off very quickly.
If you want some stronger pain relief than gas and air, you can ask for a strong painkiller to be administered by injection. Depending on the hospital you are in, you may be given pethidine or diamorphine, these are both strong opioids, which will help you feel more relaxed.
Both pethidine and diamorphine take around 20 minutes to take effect and they are not recommended if you are getting near to the second stage of labour where you will be pushing your baby out. This is because the drugs can have an impact on your baby if you have them too close to the birth and may make them sleepy and reluctant to feed. In some cases, it can even affect your newborn’s breathing.
Pethidine and diamorphine are both very effective at managing pain but some people find it makes them feel sick and they may feel light-headed and unsteady. However, it is usually given with an anti-sickness drug to prevent this.
Unlike the other pain relief options which will make your contractions easier to deal with, an epidural can take the pain away completely. A form of local anaesthetic, it needs to be administered in hospital by an anaesthetist.
It works by numbing the nerves which carry pain signals from the birth canal up to your brain. You may need to stay on your bed unless you are offered a mobile epidural, which will allow you to stay active and move around during labour.
If you have an epidural, a very thin tube will be placed into your back which medication can be administered through and you will need to have a drip in your arm which will pass fluid into your vein to help you maintain good blood pressure. Don’t worry, there are no needles left in your back. Epidurals take time so you will not be able to have one if you are in a late stage of labour. Usually once you have reached fully dilated it is deemed too late to get an epidural. It can also take a while to get the medication levels right so it is completely effective but it can be topped up.
When you have an epidural, both you and your baby will need to be monitored. Epidurals can slow your labour down, however, this extended time is not usually noticed as people often enjoy a well earned nap once they are comfortable. If you cannot feel your contractions, you may be given a little extra encouragement and guided as to when you need to push. You are more likely to need help in delivering your baby and forceps or a ventouse may be used.
A catheter will likely be recommended to help you pass urine and protect your bladder and your back may feel a little tender where the tube was inserted for a couple of days.
Remifentanil is a painkiller which goes into a vein in your arm and you can administer it yourself by pushing a button. This is known as a PCA (patient controlled analgesia) It is fast-acting but it also wears off quickly and you will be able to use it throughout your labour.
If you choose to have remifentanil, your oxygen levels will have to be monitored as it can make you breathless. Your midwife will place a small clip on one of your fingers to do this.
Some people find remifentanil makes them feel nauseous, tired, itchy or dizzy but these side-effects will disappear quickly once you stop taking the drug.
Giving birth in a birth pool can help you manage your pain and the water will help you relax. You will need to let the hospital know that you would like a water birth and a pool will need to be available for your use.
Some women use the birth pool to help them manage the pain during labour but get out before delivery, while others will stay in the water for the birth itself.