Skip to navigation. There are many ways of helping to relieve pain and discomfort during labour. These can range from simple things such as relaxing in water, walking about and TENS machines to entonox gas and air , pethidine and epidurals.
You will be given a separate leaflet on pain relief. All women are different and one method of pain relief may work well for some and not for others. It is best to keep an open mind and, if something is not working well, try something else. Please discuss the different kinds of pain relief available with your midwife, doctor or the anaesthetist. It will also be discussed in antenatal classes. TENS or transcutaneous electrical nerve stimulation works by attaching four pads to your back through which continuous electrical impulses are sent.
This blocks pain signals to your brain and also stimulates your body to produce endorphins. Labour can last a long time so, at the beginning, try movement, upright positions , massage and water to help you cope.
Lying on your back can make your contractions slower and more painful. Water soothes pain and, in a large birthing pool, supports you, enabling you to glide into any position. For more about water births and using water during labour, see here. A TENS machine transmits mild electrical impulses to pads on your back. These block pain signals and help your body to produce endorphins. For more about the pros and cons of TENS, see here. Various complementary therapies are available, such as acupuncture, aromatherapy, reflexology, yoga , self-hypnosis and massage.
Sterile water injections involve injecting a tiny bit of water into the skin of your lower back to help with back pain during labour. For more about sterile water injections, see here. Entonox is a colourless, odourless gas made up of half nitrous oxide and half oxygen. You'll probably be given gas and air through a mouthpiece and told how to breathe it in. Read more about Entonox here. Pethidine, diamorphine and meptid are pain relieving drugs given by injection into the thigh.
You may find that natural pain management techniques are enough for you throughout your labour. For most women the intensity of labour increases as they move into active labour. Contractions will get closer together and will last for longer and become more intense. This means you will have an idea, at any one time, of what the next ten or twenty minutes will bring, which gives you time to think ahead and get a sense of whether you would like additional pain relief.
Some women find a transcutaneous electrical nerve stimulation TENS unit helpful before labour becomes established. A TENS unit consists of a set of pads placed over your lower back connected to a small device which you can control yourself. The pads transmit mild electrical impulses to your back, aiming to help block pain signals before they reach your brain, and to encourage your body to produce natural painkilling chemicals called endorphins.
A TENS machine can be used throughout labour, unless you are in water or your baby has to be monitored electrically when it can interfere with the monitor signal. It has no side-effects for you and your baby, and is completely in your control. Some women find a TENS machine very helpful, others less so. Studies suggest it is most effective in the early stage of labour, when lower back pain is common.
If you want to use a TENS machine, you need to hire, borrow or buy one in late pregnancy. It doesn't really smell of anything, although the breathing mask you need in order to use it may have a faint plastic smell. You use gas and air through a mouthpiece with a 'demand valve' which releases the gas as you breathe in, so that you completely control how much you take in, and when you do so.
It takes about 20 seconds to work and about two minutes to reach its peak. Many find that it lives up to its name of laughing gas by making them feel cheerful, relaxed and even euphoric. Others say that it reduces the pain so that they feel able to manage it.
It doesn't harm your baby and it can be used in most situations. However, some women don't like the slightly groggy sensation it can cause at first although this often wears off and it can make your lips and mouth a little dry so you should take plenty of sips of water to counter this. All work in a similar way, to relax you and reduce the sensation of pain, although pethidine is the one you are most likely to be offered. Opiate painkillers are available in hospitals and birth centres, and pethidine is also used for some home births.
If you are planning a home birth you should ask your midwife in advance if they are happy to use pethidine during your home birth.
About 1 in 4 women use an injected opioid during labour. These painkillers are given by injection into your thigh, usually combined with an anti-sickness medicine, as they may otherwise make you feel sick.
Pethidine and other injected opiates Pethidine is most useful in the earlier stages of labour, when it helps you relax and may enable you to get some rest. It can make you drowsy and make you lose track of time. It takes minutes to work and each injection lasts for hours. Your midwife may repeat the dose after one to three hours if it isn't having enough effect. Sometimes pethidine can be given by a pump that you control yourself by pressing a button on the pump.
Pethidine should not be given too close to the birth of your baby, as it can affect the baby's breathing and make them sleepy after birth. It may also make you too drowsy to push effectively. For this reason, you won't normally be offered pethidine if your midwife thinks that your first stage of labour is nearly over. There is an antidote, naloxone, which can be given to you and to your baby if the midwife needs the pethidine to wear off quickly. Pethidine and the other opiates isn't for everyone - it doesn't cut out pain altogether and it can make you feel out of control.
Some women find the side-effects unpleasant, and some women find it slows their breathing so that they need to use oxygen through a mask. Pethidine and the other opiates can make your baby drowsy and affect their breathing after birth, which can make it more difficult to get breastfeeding started.
Patient-controlled intravenous anaesthesia PCIA Sometimes an opiate medicine is offered not as a single injection but as an infusion, a tiny quantity at a time, via a pump into a vein. PCIA is set up by an anaesthetist, who will explain how to use it. PCIA allows you to control the amount of opioid medicine you have safety devices prevent you from accidentally using too much.
In a few maternity units, PCIA uses an opioid called remifentanil, a short-acting medicine which is less likely to affect your baby after birth, but which is more likely to slow your breathing. An epidural is a type of anaesthetic block which works by putting local anaesthetic and painkillers directly around the nerves that bring pain signals from your womb uterus , the neck of your womb cervix and your perineum, close to where they join the spinal cord in your back.
It is the most effective way of relieving pain. An epidural anaesthetic is injected into the epidural space. This is one of the outer protective layers around the spinal canal and is a cushioning space containing blood vessels and fat. Crucially, the roots of the nerves that join the spinal cord and carry pain sensation from your lower body pass through the epidural space. The epidural space is separated from the subarachnoid space in which the spinal cord lies by a tough membrane called the dura.
Siting an epidural is a specialised task performed by an anaesthetist. You'll need to have an intravenous drip sited first, so that you can be given fluids. The anaesthetist will usually put the epidural in place between contractions. Pain relief in labour. What is a controlled medicine drug? Common health questions. NHS Choices. Intrapartum care: care of healthy women and their babies during childbirth.
London: NICE. National Perinatal Epidemiology Unit. Oxford: NPEU. Coping strategies in labour. Patient information. Parenteral opioids for maternal pain management in labour. Show references Hide references.
0コメント