Pain Relief Options During Labor
No one can predict howlabour will feel. Some find it relatively painless whilst others need quite a lot of help to overcome the pain. Getting to know what options are available to you beforehand can make deciding in the midst of a contraction a lot simpler!
Gas and air
Also known as Entonox, this gas is a 50-50 mixture of oxygen and nitrous oxide and is inhaled through a mouthpiece. It is colourless, and takes the edge off contractions. You can use gas and air in home and water births (get into special birthing pool to use water for labour) too. It’s totally under your control, can be used at any stage of birth and is easily combined with other pain relief options. Gas and air doesn’t stay in your system for long and will not harm your baby.
If you use gas and air for a long period it can be very tiring so you may need to use it in conjunction with another pain relief option.
Remember to start breathing the gas and air the very second you feel a contraction beginning. If you wait until the contraction really hurts, it will be working in between contractions, which will not be of much benefit. Gas and air can give you a dry mouth or make you feel sick so keep a cup of water handy.
TENS machine (Transcutaneous Electrical Nerve Stimulator)
A TENS machine clips onto your clothing and produces pulses that prevent pain signals from reaching your brain. It has four pads, which are placed on your back. These are connected to a small monitor by wires. Especially helpful in the early stages of labour, it helps your body to release its own, natural ""feel good"" chemicals, called endorphins. You can move around whilst using a TENS machine, there’s no effect on your baby plus you can even use it in home births.
You control the pulses according to the level of pain you’re experiencing. It takes about an hour for your body to really start responding to the TENS machine; so start using it at the very beginning of your labour to get the most benefit. As very few hospitals provide TENS machines, it’s worth hiring one and using it at home beforehand if needed.
Most women find a TENS machine works best in the first half of labour. You might have to take it off if your baby’s heart needs monitoring, you want a massage or if you enter a birthing pool (special pool used for labour). Bear in mind removing a TENS machine can interrupt the release of endorphins but you can combine it with other options to reduce pain.
This painkiller is a synthetic version of morphine and has many advantages:
- It only takes around 20 minutes to start working.
- Pethidine is either injected or provided via a tube, which you can control.
- But it’s always safer to consult your doctor on the use of such painkillers
Pethidine is usually given with another drug to stop the feelings of sickness that may occur. It can only be given during the first stage of labour or before you are fully dilated.
Pethidine can slow down your labour. If given shortly before birth it can affect your baby’s breathing and feeding and make them quite sleepy. If necessary your baby can have an injection to reverse the effects of the drug so don’t let this stop you considering it. The majority of women have safely and successfully benefited from using pethidine.
This can be given when you need extra help to cope with strong contractions and usually starts working in just 15 minutes. You can take it at any time during the first stage of labour. Meptid has the same advantages as pethidine but does not seem to affect your baby’s breathing as much. However, it could make you feel dizzy and/or sick.
As Meptid is not available everywhere, check with your doctor beforehand whether your hospital does use it.
For 90% of women an epidural makes their contractions totally painless. As it doesn’t cause drowsiness or give you a foggy head, you’ll be able to really get back in control of your labour. An epidural is basically a local anaesthetic (similar to the stuff dentists use to numb your mouth) that is injected into your lower back or delivered by a drip, which has a timed release or is controlled by you.
Epidurals can be fantastic at helping you through childbirth; so don't be put off by the side effects. The fact is most women sail through with no problems; it’s most likely that you will too. If you do want to have one, check your hospital has an anaesthetist available and bear in mind that it isn’t available for home births or in some birth centres.
When can you have an epidural?
Most women have an epidural when their cervix is about five to six centimetres dilated and the contractions are strong. If you are dilated any further it may be too late to be given one and your doctor may suggest you use another form of pain relief.
What are the side effects?
An epidural can make labour longer, especially the pushing stage. If it hasn’t worn off, your obstetrician or doctor may need to tell you when to push during the second stage of labour. It’s worth discussing with your obstetrician or doctor whether you should let your epidural wear off for the second stage of labour so that you can feel the contractions and push more effectively during delivery.
Another side effect is that it can also sometimes prevent the baby moving into the best birth position – but you can be given an assisted birth to help this.
An epidural does make it hard to move around and you may feel shivery. It can also causes a drop in blood pressure, though you'll have a drip to counteract that. You may be fitted with a catheter, which is a small tube inserted into your bladder as it's common to have problems getting out of the bed to use the toilet after birth as you can’t tell when you need to empty your bladder. Once the doctor confirms that it is safe for you to move around, it will be taken out. On rare occasions epidurals can cause bad headaches, but this is easily treated.
This is quite new and great at removing pain during childbirth. Unlike an epidural, you’ll still be able to feel your legs. And that should reduce the chances of needing an assisted birth, as you'll be able to push far more effectively.
Mobile epidurals are given like a traditional epidural. You can have one even before the first stage of labour. It’s basically a combination of anaesthetic and pain relief drugs. Unlike a traditional epidural, you have fewer side effects, probably some itchiness.
However, not all hospitals offer them so it’s best to check before you write your birth plan.
Combine Spinal Epidural (CSE)
If you need to stop pain fast but want to be able to move around, this should do the trick. CSEs are given during the first stage of labour. A painkiller is injected into your back at the same time as an epidural is set up. As the spinal injection wears off, an anaesthetic will be delivered through your epidural to ensure you stay pain-free. A CSE has the same side effects as a traditional epidural but delivers great relief.
Spinal (local anaesthetic)
If you don’t want to feel any contractions or pain during the second stage of labour then this is ideal, especially if you’re going to have an assisted birth. Spinals are occasionally used during the first stage of labour, combined with an epidural.
When you have a spinal you’ll be given an injection of local anaesthetic to the small part of your back using a very fine needle. You’ll have immediate pain relief for two hours but it cannot be topped up after. This is why a spinal is usually combined with an epidural (and consequently has similar side effects) ensuring you enjoy a pain-free childbirth!
Disclaimer: All content on this Website is provided solely for informational purposes and is not intended as a substitute for medical and/or other professional advice for your specific condition. Please do not disregard medical and/or other professional advice or delay seeking it because of something you have read on this Website. Always seek medical advice before starting any new treatments.
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