Pain relief in labour

Ask your midwife or doctor to explain what is available so that you can decide what is best for you.

Write down your wishes in your birth plan, but remember you may need to be flexible. You may find that you want more pain relief than you had planned, and more effective pain relief may be advised to assist with delivery.

Types of pain relief

Self-help

Have confidence in your ability to labour and have a positive attitude. Using relaxation, breathing, moving about and having a partner to support and massage you will all help you to have a satisfying birth experience.

Fear makes pain worse, and many people feel frightened of what they don’t understand or can’t control. So learning about labour from antenatal classes, or from your midwife, and from websites like this one are important first steps towards helping yourself cope during labour.

You can also:

• Try different positions during labour and birth as moving can make a real difference. Being upright, particularly walking around helps labour to progress. Some women like to kneel, or rock backwards and forwards. Some women like to be massaged, whereas others don't like to be touched.
• Feeling in control of what is happening to you is important. Please ask the midwife supporting you if you need to have things explained.
• Having a partner, friend or relative you can ‘lean on’ and who can support you during labour certainly helps. We know that a supportive birth partner reduces the need for extra pain relief. If you don’t have anyone, don’t worry – your midwife will support you.
• Try to relax, listen to your body and keep calm
• Warm water really helps
• If you are in hospital encourage us to dim the lighting for you. The following are known to help

‘Gas and air’ (Entonox)

This is a mixture of oxygen and another gas called nitrous oxide. You breathe it in through a mask or mouthpiece that you hold yourself.

Gas and air won’t remove all the pain, but it can help by reducing it and making it easier to bear. Many women like it because it’s easy to use and you control it yourself. The gas takes 15–20 seconds to work, so you breathe it in just as a contraction begins.  There are no harmful side-effects for you or the baby, but it can make you feel light-headed. Some women also find that it makes them feel sick or sleepy or unable to concentrate on what is happening. If this happens, you can simply stop using it.

If you try gas and air and find that it does not give you enough pain relief, you can ask for an injection as well.

TENS

This stands for transcutaneous electrical nerve stimulation.   It lessens the pain for many, but not all, women. There are no known side-effects for either you or the baby, and you can move around while using it.

Electrodes are taped onto your back and connected by wires to a small battery-powered stimulator known as an obstetric pulsar. You hold the pulsar and can give yourself small, safe amounts of current.

It is believed that TENS works by stimulating the body to increase production of its own natural painkillers, called endorphins. It also reduces the number of pain signals that are sent to the brain by the spinal cord.  For best effect it is recommended to start use in early labour.

If you’re interested in TENS, learn how to use it in the later months of your pregnancy. Ask your midwife.

Pethidine injection

Another form of pain relief is the injection of a pain-relieving drug, pethidine. It takes about 20 minutes to work and the effects last between two and four hours. It will help you to relax, and some women find that this lessens the pain.  You can also use Gas and Air with this.

Epidural anaesthesia

An epidural is a special type of local anaesthetic.  

An epidural is given by an anaesthetist, so, if you think you might want one, check with your midwife beforehand (perhaps when you’re discussing your birth plan).  Will have the chance to talk to an anaesthetist about epidural before having one.

Anaesthetic is injected into the space between the bones in your spine through a very thin tube. It takes about 20 minutes to get the tube set up and then another 15–20 minutes for it to work. The anaesthetic can then be pumped in continuously or topped up when necessary.

An epidural can be very helpful for those women who are having a long or particularly painful labour or who are becoming very distressed. It takes the pain of labour away for most women.

• You may find it difficult to pass water and a small tube called a catheter may need to be put into your bladder to help you.
• You will need to have a drip on your arm to give you fluids and help maintain adequate blood pressure.
• You may not be able to get out of bed during labour and for several hours afterwards.
• You will need to have the baby's heart beat monitored for 20 minutes after the epidural has been sited and following any top ups baby’s heart will need to be continuously monitored by a machine. This means having a belt round your abdomen  
• If you can no longer feel your contractions, the midwife will have to tell you when to push rather than you doing it naturally – sometimes less anaesthetic is given at the end so that the effect of the epidural wears off and you can push the baby out more effectively.  

If you don’t want any of these kinds of pain relief, you are free to say so. And if you decide you do want pain relief, ask for it as soon as you feel you need it without waiting for it to be offered.

This page was last modified on Thu Jul 29 2010