During my FitMama™️ Pregnancy class last night, one of the mums raised her concerns about feeling confused by pain relief choices in labour. She had attended an event with her birth partner which outlined the options and the side effects of all the options available. She came away feeling even more confused. I love it when topics like this are raised in class because you can guarantee there will be other mums feeling the same. So we debated and I gave them my 9 simple steps to helping them figure it out.
First though, let’s look at the options…
Self Help In Labour
Learning about your body and how to understand the sensations of labour will increase your confidence and ability to cope.
Learning how to relax and stay mobile during labour is a fantastic natural approach to managing the intense sensations you are likely to experience.
Breathing techniques, like those I teach in my classes and book, can greatly improve how you cope with the intense sensations of labour.
A birth partner, whether it be your life partner, a relative or friend, or simply your midwife, will greatly help you when you feel like you can’t do this. Having that emotional support to remind you that you can will keep your spirits lifted and help you remain positive.
Using water in labour (water birth)
Being in water can help you relax and make the contractions seem less painful. Ask if you can have a bath or use a birth pool. The water will be kept at a comfortable temperature, but not above 37.5C, and your temperature will be monitored.
Having delivered my third baby in water, I am a total water birth convert. It was an incredible experience, and really helped my very strong contractions which were only 30 seconds apart! Intense! Thank goodness for feeling weightless.
This stands for transcutaneous electrical nerve stimulation. Some hospitals have TENS machines. If not, you can hire your own machine.
TENS has not been shown to be effective during the active phase of labour, when contractions get longer, stronger and more frequent. It’s probably most effective during the early stages, when many women experience lower back pain.
TENS may also be useful while you’re at home in the early stages of labour or if you plan to give birth at home. If you’re interested in TENS, learn how to use it in the later months of your pregnancy. Ask your midwife to show you how it works.
How TENS machines work
Electrodes are taped on to your back and connected by wires to a small battery-powered stimulator. Holding this, you give yourself small, safe amounts of current through the electrodes. You can move around while you use TENS.
TENS is believed to work by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals sent to the brain by the spinal cord.
Side effects of TENS machines
There are no known side effects for either you or the baby.
I used TENS with my second child and definitely found it worked for me. Just be careful to ensure it it switched off before you remove it though! Ouch! A little zap there…
Alternative methods of labour pain relief
Alternative treatments such as acupuncture, aromatherapy, homeopathy, hypnosis, massage and reflexology. Most of these techniques aren’t clinically proven to provide effective pain relief, but many women swear by them, particularly Hypnobirthing.
If you’d like to use any of these methods, it’s important to discuss them with your midwife or doctor and let the hospital know beforehand. Most hospitals don’t offer them for pain relief during labour.
If you want to try any of these techniques, make sure the practitioner is properly trained and experienced.
Gas and air (Entonox) for labour
This is a mixture of oxygen and nitrous oxide gas. Gas and air won’t remove all the pain, but it can help reduce it and make it more bearable. Many women like it because it’s easy to use and they control it themselves.
You breathe in the gas and air through a mask or mouthpiece, which you hold yourself. The gas takes about 15-20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.
There are no harmful side effects for you or the baby
• It can make you feel light-headed
• Some women find that it makes them feel sick, sleepy or unable to concentrate – if this happens, you can stop using it
If gas and air doesn’t give you enough pain relief, you can ask for a Pethidine injection as well.
Pethidine injections in labour
This is an injection of the drug pethidine into your thigh or buttock to relieve pain. It can also help you to relax. Sometimes, less commonly, a drug called diamorphine is used.
It takes about 20 minutes to work after the injection. The effects last between two and four hours, so wouldn’t be recommended if you’re getting close to the pushing (second) stage of labour.
There are some side effects to be aware of:
• It can make some women feel woozy, sick and forgetful
• If pethidine or diamorphine are given too close to the time of delivery, they may affect the baby’s breathing – if this happens, another drug to reverse the effect will be given
• The drugs can interfere with the baby’s first feed, which may impact on establishing breastfeeding.
An epidural is a special type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It shouldn’t make you sick or drowsy.
For most women, an epidural gives complete pain relief. It can be helpful for women who are having a long or particularly painful labour.
An anaesthetist is the only person who can give an epidural, so it won’t be available at home. If you think you might want one, check whether anaesthetists are always available at your hospital.
How much you can move your legs after en epidural depends on the local anaesthetic used. Some units offer “mobile” epidurals, which means you can walk around.
However, this also requires the baby’s heart rate to be monitored remotely (by telemetry) and many units don’t have the equipment to do this. Ask your midwife if mobile epidural is available in your local unit.
An epidural can provide very good pain relief, but it’s not always 100% effective in labour. The Obstetric Anaesthetists Association estimates that one in eight women who have an epidural during labour need to use other methods of pain relief.
How does an epidural work?
To have an epidural:
• A drip will run fluid through a needle into a vein in your arm.
• While you lie on your side or sit up in a curled position, an anaesthetist will clean your back with antiseptic, numb a small area with some local anaesthetic, and then introduce a needle into your back.
• A very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the uterus. Drugs (usually a mixture of local anaesthetic and opioid) are administered through this tube. It takes about 10 minutes to set up the epidural, and another 10-15 minutes for it to work. It doesn’t always work perfectly at first and may need adjusting.
• The epidural can be topped up by your midwife, or you may be able to top up the epidural yourself through a machine.
• Your contractions and the baby’s heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby’s head.
Side effects of epidurals in labour
There are some side effects to be aware of:
• An epidural may make your legs feel heavy, depending on the local anaesthetic used.
• Your blood pressure can drop (hypotension), but this is rare because the fluid given through the drip in your arm helps to maintain good blood pressure.
• Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby’s head (instrumental delivery). When you have an epidural, your midwife or doctor will wait longer for the baby’s head to come down (before you start pushing), as long as the baby is showing no signs of distress. This reduces the chance you’ll need an instrumental delivery. Sometimes less anaesthetic is given towards the end, so the effect wears off and you can feel to push the baby out naturally.
• You may find it difficult to pee as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.
• About 1 in 100 women gets a headache after an epidural. If this happens, it can be treated.
• Your back might be a bit sore for a day or two, but epidurals don’t cause long-term backache.
• About 1 in 2,000 women feels tingles or pins and needles down one leg after having a baby. This is more likely to be the result of childbirth itself rather than the epidural. You’ll be advised by the doctor or midwife when you can get out of bed.
I had an epidural with my first baby, and while it definitely stopped the pain I was not coping with, it did slow things down and I felt very out of touch with my body. Pushing was 10 times harder than with my two subsequent non-epidural deliveries.
9 Simple Steps to End Pain Relief Confusion
So how do you make your decision? Here is my best advice:
- Do your research and keep an open mind about the options listed above
- Trust that your body is made to do this. You are a strong warrior woman!
- Trust that your baby knows how to be born. They’re super smart!
- Believe in yourself because you CAN deliver your baby without medical pain relief.
- Remind yourself, you CAN have pain relief if you want it.
- Don’t put yourself under pressure to do either.
- Go with the flow, even if you write a birth plan, put a footnote that you reserve the right to change your mind.
- Know that it’s going to be OK, what ever the outcome.
- Most of all, chill out! Keep calm and listen to mediation for Pregnancy to keep your mind focused and positive for labour
Keep going ladies, you’re growing a whole new person!
The NHS website has more information about your options in the UK
About the blogger:
Marie Behenna is the author of The FitMama Method, published by Souvenir Press 2012 and creator of the ChillMAMA Pregnancy Meditation<<<< a href=”https://www.amazon.co.uk/FitMama-Method-complete-confidence-fitness/dp/0285640860″>The FitMama Method<<<<<<<<<<<<<<<<<<<
e and nutrition to pregnant and post partum mothers in North Hampshire, United Kingdom. www.fitmamastudio.com