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Pain Relief

You can achieve pain relief by using drugs or by non-drug methods. Here is a brief overview of your options.

Non-drug Pain Relief*

It’s important that you have mastered your chosen pain-relief method, and familiarised your birth assistant with the technique, before you go into labour. If special equipment is required, make sure it is available at home or in hospital. One method on its own may not be enough – you may need a combination for more complete relief.

Positions

Walking around, leaning against your partner or the wall, and rocking your pelvis will probably feel much more comfortable than lying on your back. There are some positions that you will probably find more comfortable than others, as these will relieve the pressure on your back.

Massage

This is a wonderful way to get reassurance from your partner and relieve discomfort, whether you’re lying, standing, or squatting. It can help particularly if you have backache in labour, as around 90 percent of women do, or if you suffer from a backache labour.

Water

Lying in warm water can be very relaxing and soothing. Immersion in water renders you virtually weightless and this brings relief from pain between contractions. Many hospitals have ensuite facilities in their delivery rooms and it is now possible to spend a large amount of time in labour in the shower or bath. It is worth checking early in pregnancy so that you know it is going to be available for you to use when you go into labour.

Visualizing

Creating images in your mind can be a very effective way of calming fear and reducing pain. As your contraction begins, imagine something that you find particularly soothing, for example warm, bright sunshine. Contractions in the first stage are opening the cervix and you may find the image of the bud of your favourite flower opening slowly, petal by petal, helpful. Many women find thoughts of waves very comforting, matching the flow of the waves with their own contractions.

Sounds

You can help to diffuse the pain and anxiety of labour by vocalising in the way you feel most helpful. Sighing, moaning, groaning, grunting are all ways of releasing tension, and you shouldn’t be inhibited, or worry about disturbing others.

Many women find that listening to music is very effective. Your birth assistant can play different pieces on a cassette recorder, according to how you are feeling. A light, uplifting piece of music may help you rise above your contraction. When your contractions intensify, more dramatic pieces of music, building to a crescendo, may help you cope with them.

Hypnosis

This isn’t something that you should try on a whim as you need to be able to respond to hypnosis very easily. Women who go into a deep trance have been able to have a forceps delivery, stitches, or Caesarean without feeing pain. A period of practice sessions is advisable, and both you and your hypnotist should be completely familiar with what you will have to do during labour and delivery.

Acupuncture

You should only opt for this method if you have already found that it can relieve pain in other situations. In addition, your acupuncturist must be familiar with labour and delivery. This may not stop you feeling pain at all, but it will certainly reduce it, and also helps to stop the nausea.

TENS (Trans-cutaneous Electrical Nerve Stimulation.)

Pain impulses conducted by nerves are blocked by an electric current, which also stimulates the production of endorphins. A battery-powered stimulator is connected by wires to electrodes that are placed on either side of your spine. You are then able to use a handset that regulates the amount of stimulation, enabling you to control the amount of pain-relief that you receive. Ask your doctor, midwife or obstetric physiotherapist if this method is available for you to use when you go into labour.

Drug Relief

Gas or Entonox

Entonox is a brand name commonly used for the mix of 50 per cent nitrous oxide, and 50 per cent oxygen, sometimes known as gas and air. The percentage of oxygen and nitrous oxide can be adjusted to suit your individual pain relief needs. The gas is in a cylinder, attached to a tube and mouthpiece, or a mask you place on your face. Breathing in delivers the gas to you automatically. It is quickly expelled from your body, and you can’t overdose on it. Your baby isn’t affected – very little of the gas reaches him

Pethidine

Pethidine, diamorphine and other similar opiate drugs related to morphine are injected, usually in your bottom. Effects vary – some women find it helpful and relaxing; others don’t like the way it makes them feel ‘spaced out’, and they may be sick. It can affect the baby’s breathing at birth, and make him sleepier for two or three days afterwards depending on when it is administered.

Epidural Anaesthesia

Epidural anaesthesia means an anaesthetic drug is injected into the epidural space at the side of the spinal cord. A catheter – a fine plastic tube – is left in at the injection site, so more anaesthetic can be given as a top up. It gives total pain relief for most women. It may mean you have no feeling at all in the lower half of your body, which may make it harder for you to push later (which can mean a forceps delivery is more likely, particularly if it’s your first baby). It can also increase the length of your labour. This numbness will last for some hours. Mobile epidurals mean some feeling remains in your legs so you move. Babies don’t seem to be affected.

* Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002