Pain Relief
Labour is painful, so it's important to learn about the ways you can relieve pain in labour and how your partner/labour supporter can help you. Ask your midwife or doctor to explain what is available so that you can decide what's best for you. Bear in mind that you may need to be flexible with any plans you make when the labour actually happens.
Types of pain relief:
Self-help
Using relaxation, breathing, keeping moving, having a partner to support and massage you, and having confidence in your own body will all 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 which you hold for yourself. You'll probably have a chance to practice using the mask or mouthpiece if you go to 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. 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.
Injections
Another method of pain relief is via an injection of a pain relieving drug, usually pethidine. It takes about twenty 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 people very 'woozy', sick and forgetful. If it hasn't worn off when you need to push, it can make it difficult. You might prefer to ask for a half dose iniitally to see how it works for you. 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
An epidural is a special type of local anaesthetic. It numbs the nerves which carry the feelings of pain from the birth canal to the brain. So for most women an epidural gives complete pain relief.
An epidural is given by an aneshetist. While you lie on your side 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 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 difficult 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. Disadvantages of an epidural are:
- 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 the right blood pressure;
- You may not be able to get out of bed during labour and for several hours afterwards;
- Your contractions and the baby's heart will need to be coninuously monitored by a machine;
- 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.
