Coping with pain during labour – what are the options?
Labour can be long and tiring and as it progresses the pain you feel during contractions will intensify. It’s a good idea to have some understanding of the pain relief options that will be available to you as well as the effects they may have on your labour.
Giving birth is not the same experience for every woman. In some cases it may be more bearable than you expect and pain relief, or the level of relief you thought you’d need, is not required. On the other hand, if you plan to have no pain relief, or as little as possible, it may be that you will need to re-consider once the labour progresses.
So, the main advice is to be flexible if you need to be on the day.
Being informed, making plans
Knowing what will happen during labour is important, even though the information may be a little scary. The more informed you are the better you will be able to cope mid labour.
All mothers-to-be will given the chance to discuss pain relief with their midwife, but it’s a good idea to attend antenatal classes. At these sessions you will be provided with comprehensive information about the various pain relief options available and you can ask questions or listen to the group queries.
If you are making a birth plan – which is a very good idea – you can note down your hopes for pain relief, this can then be shared with the labour ward when you arrive.
Different stages and useful coping strategies
During the first stage of labour, you may find that you can cope during the contractions without any form of pain relief. However, as they begin to get more regular and last for longer, you might decide to use some coping strategies. Suggestions and methods for this stage can be whatever makes you feel most comfortable, popular methods include:
- taking a warm bath or shower
- practising breathing techniques
You can buy or hire a TENS (transcutaneous electrical nerve stimulation) machine, which stimulates the body to produce its own natural painkillers via a safe level of electrical current triggered by electrodes. The current is produced through wires which are attached to your back and which you control when your contractions start. Many women have found them to be useful in the early stages of labour.
Later as your contractions continue to dilate your cervix further you may find that your energy levels and ability to cope may be decreasing. If at this point you choose to ask for medical pain relief, there are number of options that will be offered to you.
Gas and air (entonox)
Gas and air is a long proven source of pain relief for women in labour and is popularly used to take the edge off the pain felt. It is simple to use, fast acting and is something that women can self-administer as the pain rises during a contraction.
If you use gas and air you will be given a mask or mouthpiece to hold. When you feel that you would like to use the gas you hold it to your face and breath in with slow, deep breaths just as the contraction begins. Usually, the relief will take about 20 seconds for full effect and wear off quite quickly.
Gas and air has no known or harmful side effects but it can make you feel a little nauseous and/or light-headed.
Pethidine is a stronger form of pain relief, which is given to you via an injection in your thigh or buttock. It will help to reduce the pain and allow you relax. Once the pethidine has been administered it will take up to 20 minutes to work and the pain relief effect will last between two to four hours.
Taking pethidine during labour may make you feel nauseous and sometimes cause you to be forgetful. Taken in the later stages of labour, there is a possibility that you might find it harder to push but you will be advised and it may be suggested you take a half does nearer to this point.
There is also a chance that the drug may affect your baby’s breathing, and when your baby is born they will need to given an antidote drug to reverse any effects. Pethidine may also affect your baby’s first feed.
An epidural is the strongest medical form of pain relief administer during normal labour. It provides a numbing sensation to the pain felt during labour. Although many mothers-to-be are concerned about epidural pain relief, sometimes it can be extremely effective for women who are having a lengthy or very painful labour, which is causing distress.
The drug is a mixture of a local anaesthetic and opioid. It is only possible for an epidural to be administered by a hospital anaesthetist. The process will require you to have a drip inserted via a needle in a vein in your arm. The anaesthetist will then ask you to lie on your side or sit on the edge of the bed.
When you are ready you will need to slightly curve your back whilst a local anaesthetic numbs a small area of your back and a needle put in place. A thin tube will be inserted through the needle and the epidural drug will be administered. This is positioned near to the nerves carrying pain messages received by the brain from the birth canal and dramatically reduces the discomfort you will experienced.
Although an epidural can provide powerful pain relief it is not always a cure-all solution. Many women still find that they need to use other methods to help manage the pain. Your anaesthetist will also monitor the level of relief you are receiving and can administer a top up as necessary.
Once the epidural is administered you will remain in your bed, as it is likely you will experience reduced movement or heaviness in your legs. In some hospitals, they have facilities for mobile epidurals, in which case you will be able to walk around. Your baby’s heart rate will be monitored at the same time to ensure its wellbeing.
A common side effect of having an epidural is that it can prolong the second stage of labour. The numb sensation means that you may not feel the contractions, so your midwife will need to tell you when to push. Sometimes your baby will require intervention to be delivered via the use of forceps or ventouse.
Alternative pain relief options
There are of course some women who wish to avoid the drug-based pain relief offered in hospital. Popular techniques include:
- chanting and breathing exercises
It is important to discuss this with your midwife if you would prefer to try any of the above approaches. The NHS advises that you ensure you have consulted with a properly trained expert if your chosen method needs to be administered during labour.
Above all, your choice of pain relief is totally up to you. Midwives and maternity staff will be on hand to advise you, and, of-course, if you change your mind at any time about a certain method of pain relief which you felt you would not want to take advantage of, that is entirely your choice.