Pain relief options during labour

There are different ways to help ease the pain during labour and you can ask for pain relief at any time. You can choose one method or a few, and you can start with natural methods such as breathing and relaxation techniques, having a bath and using a warm flannel compress.

Focusing on breathing in through the nose and out through the mouth is a helpful way to focus on the contractions and steady your breathing from the start to the end of the contraction.

Aromatherapy must always be used with caution and only with advice from a midwife who has trained in using aromatherapy oils, this is because some oils can be dangerous to use during pregnancy and in labour.

TENS machine

TENS stands for Transcutaneous Electrical Nerve Stimulation, and you can hire a machine prior to labour. A TENS machine can be used at home when your labour begins, before you go into hospital.

The machine works by sending small, safe pulses of electrical current via sticky pads on your skin. These are held in place on your back and give a gentle buzzing sensation through the skin and into your muscles and tissues. You can control the intensity of the sensation yourself as labour progresses.

There are no side effects from using a TENS machine and it can provide pain relief all the way through labour, however once in the active phase, it may no longer be as effective.

Entonox

More commonly known as gas and air, Entonox is pain relief that you breathe in through a mouth piece or mask. It is the most common method of pain relief that is effective from the start to the end of each contraction.

It can be used at the same time as other forms of pain relief, like pethidine or diamorphine. It works within a few seconds and wears off quickly when you stop. You might feel a little bit sick initially, but this usually passes. It does not affect the baby and can be used at any stage of labour for as long as you need it. You can also use Entonox for pain relief when in a birthing pool.

Epidural

An epidural is an injection in the spine to stop you feeling pain by numbing only a specific part of your body. It is commonly used during labour for pain relief.

An epidural is a local anaesthetic which is injected into the area around the spine by an Anaesthetist to give continuous pain relief.  You can have an epidural at any point if you choose to during labour, and your midwife will discuss the advantages and disadvantages with you. Once your epidural is in place you won’t be able to move around the room and it will stay in until after your baby is born.

Epidurals are very effective methods of pain relief and better at relieving pain than pethidine or diamorphine, however your baby will need careful monitoring throughout labour once it’s in place.

Pethidine and diamorphine injection

Pethidine, diamorphine and similar drugs (known as opioids) can be given as injections for pain relief. They start to work after about 10 to 20 minutes and may make you feel a bit sleepy. It will take around two to four hours to wear off.

One of the side effects is nausea so you may be given an anti-sickness injection at the same time. It is important to understand that your baby’s breathing may be affected after using these methods of pain relief, and if this does happen, they may need an antidote injection and regular observations.

Pethidine can remain in the baby’s bloodstream for up to 62 hours. This can sometimes make your baby feel more sleepy, because of this, you may find it more difficult to establish breastfeeding.

Using a birthing pool

Some people find that using a pool during labour can help to lessen their labour pains. You’ll need to ask about a birthing pool when you arrive as some birthing centres may have limited facilities or capacity.

You should enter the pool when you are established in the active phase of labour, when your cervix is 5-6cm dilated and you are having strong, regular and powerful contractions. You can use gas and air at the same time as being in the water.

The water temperature is kept warm, so you can stay in as long as you like. You can get out to deliver your baby or you can stay in if you wish. Your midwives can keep an eye on your baby’s progress with a waterproof monitor.

Water aids mobility and you may find it easier to move into different positions, such as squatting, leaning on to the sides or floating. There are no side effects to a water birth and your partner can join you in the pool too.

You can wear whatever you feel comfortable in, however t-shirts can become heavy and cold if you stay in the pool for a long time. Your partner will need swimwear too if they join you in the water. When a baby is born in water, your midwife will bring them straight to the surface but, as they are still receiving oxygen from the umbilical cord, they won’t breathe until they feel the air and the change in temperature. As soon as they reach the surface, they’ll take their first breath.

Useful links

• NHS – Pain relief in labour
• Tommy’s – Pain relief in labour and birth
• Health for Under 5’s – What to expect after your baby’s birth