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Pain Relief in Labour

There is no doubt about it, giving birth hurts. It is not 'discomfort', 'intensity' or any of the other euphemisms beloved of books and articles on childbirth; it is pain.

Women who are not expecting birth to be painful may panic during labour, or feel like failures as they accept pain-relieving drugs. It is being prepared, and how you react to and deal with the pain you experience, that makes the difference between your labour being a manageable, empowering experience and an ordeal.

Each woman experiences the pain of labour differently. Some women cope better with pain than others, and learning strategies to work with the pain during pregnancy will help you to cope. Knowing what is happening to you means you are less likely to feel anxious.

NATURAL TECHNIQUES

There are many non-invasive ways to help you with your labour pains. In early labour, massage can be a great help, as can a warm bath. Homeopathic remedies and acupuncture can also help. Concentrating on your breathing, especially relaxing 'out breaths' such as those described by Sheila Kitzinger in her book The Experience of Childbirth, can help to keep you calm and centred. Many childbirth preparation classes include breathing techniques to help you throughout labour.

Staying mobile and regularly changing position can also be a great help. You may find that leaning against a wall helps, or resting on all fours, gently rocking your pelvis. Try sitting facing backwards on a chair in an upright posture with your legs apart. Visualising may help you. Imagine your baby moving down the birth canal, and remind yourself that every contraction is bringing your baby closer to being born. Remind yourself that labour will not last forever!

TENS

Transcutaneous electrical nerve stimulation (TENS) may be of help in labour. To use a TENS machine, adhesive pads are attached to your back. A low-voltage electric current is passed through the pads and this makes your body produce endorphins, your own natural pain-relieving substances. It takes about 30 minutes before you feel any effect, so it is worth using in early labour. You control the strength of the electrical current through a hand-held device. TENS machines have no reported side effects for mothers or babies.

GAS AND AIR (ENTONOX)

Entonox is fabulous! It is a mixture of oxygen and nitrous oxide (laughing gas). When I used it I felt pleasantly tipsy, which was quite a welcome sensation after all those months without Merlot! For the pain relief to work you need to start breathing in the gas through the mask or mouthpiece as soon as you feel a contraction start. This coordinates the pain-relieving effect with the peak of your contraction. Entonox crosses the placenta but there are no known effects. The oxygen in the gas may actually help your baby.

Entonox may give you a dry mouth, so suck ice chips or sip water between breaths of gas.

PAINKILLING INJECTIONS

If you find the pain of labour hard to bear, painkilling drugs such as diamorphine, pethidine and meptazinol can be given to you by injection into the thigh or buttock. These drugs take around 20 minutes to work, and the effects last for between two and four hours. You may have more than one dose during your labour. These drugs do have side effects. They can make you drowsy and nauseous and can even slow your breathing down. They are not usually given too close to the birth of your baby as the drugs can make the baby drowsy and slow to breathe too.

EPIDURAL

The nerves from your uterus and birth canal are linked to your brain - where you 'feel' pain - through your lower back.

When an anaesthetist gives you an epidural, a tube is inserted in a space between your vertebrae, and painkiller is injected. An epidural gives excellent pain relief but may have side effects. Your blood pressure might get low so a drip is routinely set up. This, along with the need for a foetal heart monitor and a catheter, means you are confined to bed. You may also experience heaviness in your legs. Very rarely spinal fluid can leak, causing headache and backache. An epidural is useful if a woman has a Caesarean section, as she may stay awake throughout.


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