Labour is a natural, but painful experience, so it’s important to learn about all the ways you can relieve and cope with the pain and how your partner or labour supporter can help 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. Pain relief available is as follows:-
Self-help
Using relaxation, breathing, keeping mobile, having a partner to support and massage you, and having confidence in your own body will all help.
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, from your doctor or midwife, and from websites like this one, is an important first step towards helping yourself cope with the pain of labour.
There are things you can do for yourself:
- Learning to relax helps you to remain calmer.
- Antenatal classes place the emphasis on being fit and what your choices are, so that you feel you have more control in labour.
- Your position during the birth can also make a difference. Some women like to kneel, walk around or rock backwards and forwards. Some like to be massaged, whereas some don't like to be touched.
- Feeling in control of what is happening to you is important. You're working with the midwife and she with you, so don’t hesitate to ask questions or to ask for anything you want at any time.
- Having a partner, friend or relative you can ‘lean on’ and who can support you during labour certainly helps. It has been shown to reduce the need for pain relief. But if you don’t have anyone, don’t worry – your midwife will give you the support you need.
- Warm water and baths.
And finally, no one can tell you what your labour will feel like in advance. Even if you think you would prefer not to have any pain relief, keep an open mind. In some instances, it could help to make your labour more enjoyable and fulfilling.
Aromatherapy
Our birth units are among the first in the country to use aromatherapy techniques to help women before, during and after labour.
Your midwife will be able to tell you more about this unique service, but for more information please click on the link below:
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.
If you’re interested in TENS, learn how to use it in the later months of your pregnancy. TENS machines can be rented from pharmacies and online providers before your due date. Ask your midwife or physiotherapist for advice.
‘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.
You may have a chance to practise using the mask or mouthpiece if you attend an antenatal class. 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 lightheaded. 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.
Injections
Another form of pain relief is the intramuscular injection of a pain-relieving drug, usually 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.
However, it can make some women feel very ‘woozy’, sick and forgetful. If it hasn’t worn off when you need to push, it can make it difficult. If pethidine is given too close to the time of delivery, it may affect the baby’s breathing. But if it does, an antidote will be given.
Epidural anaesthesia
An epidural is a special type of local anaesthetic. It numbs the nerves which carry the pain from the birth canal to the brain. For most women, an epidural gives complete pain relief.
Anaesthetic is injected into the space between the bones in your spine through a very thin tube. 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 and you won’t feel so tired afterwards. But there are disadvantages:
Your legs may feel heavy and that sometimes makes women feel rather helpless and unable to get into a comfortable position.
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.
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.
Some women get backache for some time after having an epidural.