Pain Relief in Labour

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