There are several ways of helping you cope with pain in labour.
and breathing techniques and walking are some of the self-help techniques.
Some women find gentle massage, using warm water in the shower or bath
helpful. It is difficult to know before labour what will work best for you.
midwife will be able to provide you with additional information to help you
choose what suits you. Here are some facts about the main methods of pain
management available in the Rotunda.
Anti-burst gym ball
Sitting on a gym ball encourages a natural swaying and rotating motion of the
pelvis and can help to move the baby down through the birth canal. Sitting on
the ball can help to take pressure off your bottom. The way you sit on the ball is
similar to a squat, which helps to open the pelvis and speeds up labour. Gentle
moving on the ball reduces the pain of the contractions and it also means your
partner can rub your back if you would like it massaged. If you are considering
using a gym ball, please purchase an anti-burst one and make sure that it is
inflated to the recommended level.
The sense of touch has been associated with the power of healing since the
beginning of time. Touch has the power to soothe pain. Some women like a
light, stroking massage or a long stroke massage, while others like firm, circular
massage particularly if they are tense or are having back pain. Massage oils
can be used and we recommend you talk about and practise the different types
of massage with your birth partner before labour.
These relaxation techniques work by making you aware of your breathing
patterns. Focusing on how you are breathing helps you to breathe slowly
and deeply. It helps you to avoid holding your breath – holding your breath
tenses up your muscles and reduces the level of oxygen. Some women develop
techniques to help them concentrate on their breathing such as chanting a
word or poem, or focusing on just one element of the breathing cycle.
Thinking about or imagining something pleasant can encourage relaxation
and help women manage their pain in labour.
Warm or cold pack
Warm or cold packs are simple ways of easing pain and helping you to relax in
labour. You can buy heat and cold packs in your local pharmacy. An ice pack or
heat pack on the lower back can help to ease backache.
Music can help you to relax and reduce stress and tension. It might also help
you to focus on your breathing and take your mind off the contractions.
Gas and air (entonox)
This is a mixture of oxygen and another gas called nitrous oxide. You breathe
it in through a mouthpiece when you have a contraction. It acts quickly and
wears off quickly once you stop using it. While it won’t take the pain away
completely, it makes the contractions easier to cope with. It doesn’t cause any
harm to the baby and it can be used at any time during labour. It can also be
used with the TENS machine or pethidine.
TENS stands for ‘transcutaneous electrical nerve stimulation’. Four electrodes
are placed on your back, which are connected to a small hand-held device
that is battery operated. TENS has been used for back pain for many years. It
works by stimulating the nerve near your womb and your body responds by
producing natural ‘morphine like’ substances called endorphins. These are the
body’s natural painkillers. The TENS machine helps to ease the pain for some
women. There are no known side effects for either you or your baby and you
can continue to move around while using it.
It is recommended that you start using the TENS machine as soon as your
contractions become regular. As this often happens when you are at home,
you may consider renting or buying one. If you start to use it at home, you
can continue to use it throughout your labour. Some TENS machines are also
available in the delivery suite.
Pethidine is a drug that is injected into the muscle in your buttock (bottom). A
second drug is given at the same time to stop you feeling sick. It takes about
20 minutes to work and the effects last between two and four hours. It works
by easing the pain and it helps you to relax. Pethidine can make some women
feel a bit light-headed and forgetful. Pethidine slows your digestion so eating
and drinking in labour is restricted. The drug passes through the placenta to
the baby so if it is given too close to birth, it may temporarily affect your baby’s
breathing at birth and the initiation of breastfeeding. If this happens, the
midwife will give the baby a drug to undo the effects of the pethidine.
An epidural is the most effective form of pain relief during labour. The word
‘epidural’ refers to a space in your back where pain messages from your
womb and birth canal pass to the brain. An epidural involves injecting local
anaesthetic and pain relieving drugs into this space to block the sensation of
pain. If you decide you want an epidural, the anaesthetist will tell you how the
procedure works and explain the advantages and possible side effects. You will
need to sign a consent form before you can have an epidural.
It takes about 20 minutes to set up the epidural. You will need a drip in your
arm to give you extra fluids so that your blood pressure does not fall. The
midwife will help you into a sitting position or you can lie on your side. This
makes it easier to get the epidural tube inserted. You will be asked to stay very
still while the tube is being inserted.
The epidural can be very helpful for women who are having a long and painful
labour. It takes the pain away for most women. Some of the disadvantages of
having an epidural include having difficulty passing urine so a catheter (tube)
is placed into your bladder to keep it empty. Your legs may feel heavy so you
must stay in bed. Your baby’s heartbeat will be monitored continuously. If you
have an epidural for pain relief, only sips of water are recommended, as the
drugs cause the stomach to empty at a slower rate.
The risk of injury to the nerves in the epidural space is very small. This side
effect is thought to occur 1 in 10,000 times. Numbness, tingling, or weakness in
one or other leg can also rarely occur (1 in 2,000 times) following births where
epidurals have not been used.
For further information on anaesthesia please follow this link to the Obstetric Anaesthetists’ Association website
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