Your Guide To Pain Relief in Labour – By Midwife Zoe
Every woman will experience labour differently. For some, it will be a slow (for some very slow) ease into labour and for others, it will progress quickly where you don’t even make it to the hospital. Most women will be somewhere in the middle of both those extremes, yet how they cope with the pain can be extremely different.
I have seen women in active labour making jokes and telling long stories whilst contracting strongly where other women will be screaming the house down making sounds like they are being tortured. Every woman has their own story and their own perception of pain during labour so I think it is a great idea to discuss what pain relief options are available for you in the case that you may decide to use one or all of them in your labour.
There is much you can do to prepare for labour and birth. Educating yourself is probably one of the most important. BornOnline’s comprehensive antenatal classes answer all the key questions and provides all the essential information you need to go into labour and birth feeling relaxed and ready. We cover stages of labour, pain management, demonstrate position changes you can use in labour and so much more. In conjunction with the blogs and fact sheets we produce, there is no better way to feel empowered for your journey ahead then with BornOnline.
What Is The Cause Of Contractions?
Contractions start like a dull, period-like pain in your lower abdomen, sometimes radiating into your lower back causing back pain. They feel different to Braxton Hicks Tightenings you may have been experiencing. Contractions are more regular, stronger and last longer.
As labour progresses contractions become closer together, increase in intensity and last longer. By the time you reach the second stage of labour (this is the pushing stage) most women will find their contractions will actually space out, allowing you time to recover in between pushes.
What Are My Options For Pain Relief in Labour?
Many women will choose to birth naturally without any medicated pain relief and by using alternative methods of pain relief like water immersion in the bath, warm showers, heat packs, TENS machines, position changes and massage.
Other women will use all of these plus the use of one or all of the medicated options of nitrous oxide (happy gas/gas & air), morphine/pethidine, or an epidural.
Gas And Air
Gas and air can help take the edge off the contractions. It is an amazing focus point as it forces you to breathe, as most women in labour will try and hold their breath during the contraction. Gas and air can give you something to focus on during the contraction and the best thing about gas and air is that it does not harm the baby. Gas and air only last in your system for 20 seconds after you stop using it, so it has no long term effects like drowsiness or the inability to move that comes along with morphine/pethidine or an epidural.
You can use the gas and air in the shower, bath or in the bed, so it doesn’t restrict where you can move. This is a MAJOR advantage to the gas and air.
A side effect of gas and air is that some women become nauseous with it. It’s a good idea to ask for it to be started low and then slowly turn it up. This can help stop nausea. Most women are going to feel nauseous or vomit with or without the gas as those symptoms are all apart of labour so I say, Just go for it, use the gas if you feel you are not coping. We can deal with nausea with some maxolon or another antiemetic.
Some women get dizzy, tingly lips or a funny taste in their mouth. All very common side effects but very easily dealt with considering if you are choosing to have pain relief in labour THIS is the best option as it is low risk.
Morphine/Pethidine is only offered in the first stage of labour if you need help coping with strong contractions. It is a good way of postponing or even avoiding an epidural. It is given via an injection and will start to work within 20 minutes of being given. It is often used in conjunction with the gas and air and can be a good form of pain relief for most women.
While morphine can help you through contractions, it’s unlikely to be offered late in labour when it can cause breathing problems for the baby. Morphine/Pethidine crosses the placenta so we need it to have been close to wearing off before your baby is born so that your baby isn’t too sleepy at birth causing respiratory issues.
You may find that the morphine/pethidine has worn off by the time you need to push. That isn’t such a bad thing, as you need to have all your focus and energy on pushing your baby out, you don’t want to be drowsy and unable to push effectively. In the case that you are not coping in this stage, you can always look at using the gas and air.
Possible side effects of opioids are:
- Feeling nauseous or being sick (in this case, you would likely be offered a drug to help with the sickness)
- Heart palpitations or hot flushes
- You may also find your vision is disturbed
- Some women find they don’t remember the baby being born because of the ‘out-of-it’ state morphine can induce
- It could slow down your labour in which case you may need syntocinon (artificial hormone) to speed up your labour via the IV drip.
It is important to know that morphine/pethidine WILL NOT take away the pain. It will assist you in coping with the pain but it will not take away the pain, only a successful epidural can do that.
I will do a blog on Epidurals separately, as there is quite a bit of education that goes into knowing about an epidural and I would prefer to cover it in more depth so this is very brief.
An epidural will make your labour less painful or even painless depending on how successful the block is (sometimes it doesn’t work, or may take a while to work). A small plastic tube, called an epidural catheter, is inserted between the bones of your spine. A local anaesthetic is given down the tube, blocking pain in the nerves of the spine. This provides pain relief until the baby is born.
When you have an epidural, you will require an IV line (cannula) in your hand, bloods taken and sent to pathology, an indwelling catheter put in your bladder (as you won’t be able to get up and go to the toilet). You will require the CTG machine around your belly to monitor your babies heart rate as an epidural makes your labour high risk, in which case the baby may become distressed and we need to know this hence why the CTG machine is put on.
You also are at an increased risk of needing a forcep or vacuum delivery or even a caesarean section. I’ll explain why in my next blog.
Whatever you choose, feel good about your decision and don’t be hard on yourself. Labour is really really hard work!
(This article contains general information only and is not intended to replace advice from a qualified health professional. All information is written from the experience and knowledge of the person writing the post).