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When it comes to labour, the first thought
on many women’s minds is, “What pain relief is available?” Some women sail
through labour with ease, but for others it can be very painful and extra
relief is essential. There’s a variety of methods available, used in part
depending on what stage of labour you’re at, with some being administered to
you and others that you’re able to control yourself. There are issues to
consider with each method and your midwife can help you choose the most
appropriate approach. So, what methods are available?
Pethidine
What
it is: Pethidine is a drug similar to morphine.
How
it’s used: It’s given in the form of an injection,
usually in your bottom or thigh.
Effect
on the baby: Pethidine crosses the placenta and can
affect the baby. The main affect is slow breathing after birth, although a drug
can be given to reverse the effect. Sometimes babies are affected for up to a
week, resulting in feeding difficulties.
Effect
on the mother: It can make women drowsy, cause
shallow breathing, nausea (although another drug is given to prevent sickness)
and make some people feel weepy.
At
what stage it’s used: During the first stage of
labour, when contractions are gradually opening up your cervix.
For: It can be a good form of pain relief and can be used at home births,
as well as in hospital.
Against: It can’t be administered if you’re about to give birth within a few
hours, as the possible effects on your baby are increased. Some women feel like
they’ve lost control when given the drug.
TENS
Machine
What
it is: Transcutaneous Electrical Nerve Stimulation
(TENS) is a small machine that emits pulses of electricity.
How
it’s used: Wires plug into the TENS with pads on –
the pads are placed on your body, often on the lower back, and small electrical
pulses are emitted.
Effect
on the baby: There aren’t believed to be any
negative effects on the baby.
Effect
on the mother: You can move around easily and still
have gas and air.
At
what stage it’s used: Throughout labour, but best started at the
beginning and then increase the intensity as labour progresses.
For: You can try it out in advance to get used to the effect and you’re
in control.
Against:
It can’t be used if you’re having a waterbirth.
Some people find the electrical pulses uncomfortable.
Gas
& Air
What
they are: A mixture of gas and air – 50% nitrous
oxide and 50% oxygen.
How
they’re used: You administer them yourself through
a mask or mouthpiece.
Effect
on the baby: The oxygen part may be beneficial to
your baby.
Effect
on the mother: It numbs the pain centre in the
brain and lasts 60 seconds, helping you get through a contraction.
At
what stage they’re used: Best during the first
stage, when you’ve got strong contractions.
For: It won’t take all the pain away, but it does take the edge off. You
control when you have it.
Against:
Can make you feel a bit nauseous, floaty and make
your throat dry. It won’t take all the pain away.
Mobile
Epidural
What
it is: A form of local anaesthetic, which numbs the
nerves so you don’t feel pain.
How
it’s used: It’s injected into the spine.
Effect
on the baby: It can help the baby move down the
vagina more easily, as the drug relaxes the pelvic muscles.
Effect
on the mother: Unlike traditional epidurals, it
doesn’t totally block the nerves to your legs, bladder or abdomen muscles, so
you can still walk, sit up and go to the loo.
At
what stage it’s used: Epidurals can be given from
early labour and until the cervix is fully dilated.
For: It’s effective for two to four hours, doesn’t make you sleepy and
you’ll be awake for the birth.
Against:
It may add an extra hour onto the time you’re in
labour and may increase the need for intervention. Sometimes it causes blood
pressure to drop, an increase in temperature or itchy skin.
Spinal
Block
What
it is: A single dose of local anaesthetic.
How
it’s used: It’s injected between two vertebrae in
the lower spine and numbs the lower half of the body.
Effect
on the baby: No adverse effects.
Effect
on the mother: You won’t feel anything from the
waist down, for about one to two hours.
At
what stage it’s used: Often used in emergency
situations and Caesarean sections.
For: It works quickly and is good for pain relief during delivery.
Against:
The effects aren’t as long-lasting as an epidural.
Waterbirth
What
it is: A mini pool filled with warm water, in which
you can sit, move around and be in during labour.
How
it’s used: Birthing pools are often available to
use in hospitals or you can hire them at home.
Effect
on the baby: The water needs to be at body
temperature (35c), otherwise it could be a shock to the baby when born.
Effect
on the mother: Water aids relaxation, supports you
and lets you move and change position easily.
At
what stage it’s used: For just the first stage or
the whole labour.
For: It may reduce the need for
other pain relief, cut the need for assisted delivery and reduce the length of
the second stage of labour.
Against:
Some people worry there might be a small risk of infections
being spread.
By Rachel Newcombe
Pain Relief in Labour