Labour can be painful and no method of pain relief is 100% effective.
Talk to your midwife during your pregnancy about labour pain relief options. They can tell you if your maternity unit, hospital or home birth midwife can accommodate your choice.
During labour you may need less or more pain relief than you had planned. Your midwife or obstetrician might suggest options to help with the birth.
Self-help in labour
You're likely to feel more relaxed in labour and better placed to cope with the pain if you:
- prepare for it by learning about labour and going to antenatal classes
- practice relaxation and breathing techniques
- keep moving and try different positions using birthing balls and equipment - this can distract you from any discomfort you may be feeling
- bring a birth partner to support you during labour, but do not worry if you do not have a partner – your midwife will give you all the support you need
- go for a bath or shower - some hospitals may have birthing pools
Gas and air (Entonox)
You can be given gas and air (Entonox) to help with labour pain. Entonox is half nitrous oxide and half oxygen.
You breathe in (inhale) the Entonox through a mouthpiece. You hold the mouthpiece over your mouth and breathe in when a contraction begins. You can use Entonox at any time during labour.
Using Entonox will not take the pain away completely but will reduce it. It also helps to focus your breathing. It takes 15 to 20 seconds to work. It works best if you use it at the start of a contraction and take long, deep breaths.
There are no harmful side-effects to you or your baby. But it can make you feel dizzy, light-headed or a little nauseous. If you find these symptoms are bothering you, stop using it and the effects wear off very quickly.
Pethidine painkiller
Pethidine is a strong painkiller. It is a similar drug to morphine and a type of opioid. Pethidine is given as an injection into your leg or bottom. It may help lessen your pain, especially if used with other methods.
The injection can make you feel drowsy, dizzy or sick. It takes about 20 minutes to work and lasts 2 to 4 hours.
If given too close to birth, your baby may be a bit sleepy after birth.
Pethidine is not suitable for some people. For example, people with a history of epilepsy.
Epidural
An epidural is a local anaesthetic given in your lower back. A drip will be put in a vein in your arm to give you some intravenous fluids beforehand. These keep your blood pressure stable.
How an epidural is given
Before they begin, the anaesthetist will ask you to sit up in a slouched position or lie on your side.
- The anaesthetist cleans your skin and injects some local anaesthetic.
- They place a needle in your back.
- They pass a very thin tube through the needle into your back near the nerves.
- When the tube is in the right place, they remove the needle.
- The pain-relieving drugs are given through the tube.
It takes about 10 minutes to set up the epidural tube, and another 10 to 15 minutes for it to work.
A tube called a catheter will be inserted into your bladder to drain urine when the epidural is in place. It stays in place for up to 8 hours after the birth.
Your midwife will check your blood pressure regularly as sometimes it can fall.
Epidural side-effects
The epidural has a minimal effect on your baby. It does not cause your baby to be sleepy.
You may need to remain in bed for the birth. Your baby will need to be monitored during labour.
Taking an epidural may make the labour longer and reduce your urge to push down. If you cannot feel your contractions, the midwife will tell you when to push and breathe out. Forceps or a ventouse (vacuum) may be needed to help deliver your baby.
The epidural may cause a severe headache, which can be treated.
It can also cause:
- a feeling of heaviness in the legs
- low blood pressure (the fluid in your drip should prevent this)
- pins and needles down one leg
Epidurals can cause soreness in the back for a day or 2. But they do not cause long-term back pain.
TENS machine
The word 'TENS' stands for transcutaneous electrical nerve stimulation. This involves passing a gentle electrical current through flat pads on your back. The small electric current stimulates the body to produce endorphins. Endorphins are natural painkillers.
Using a TENS machine
Using a TENS machine works better if you start early in labour.
You, your birth partner or midwife tape the electrode pads to your back. These are connected to a small battery-operated stimulator. You can hold this and give yourself small doses of electric current.
Check if your maternity unit supplies TENS machines. If not, you may be able to rent one. Many large pharmacies offer these for sale or rent.
Aromatherapy and alternative therapies
Aromatherapy oils can be used:
- in massage
- in the bath
- on a tissue
- by diffuser
These may increase relaxation and reduce pain. Speak with a qualified aromatherapist and check with your maternity unit or hospital before using aromatherapy.
Other options include hypnobirthing, yoga, acupuncture or reflexology. These may not be offered in your maternity hospital or unit but may be available privately.
Talk to your midwife if you are considering any alternative methods of pain relief. Many hospitals do not provide these services but may accommodate you.