Everything Pregnant Mums Should Know About Pain Relief Options for Labour

Childbirth is painful, no matter how you look at it, but everyone’s pain threshold differs.

There are both non-medical and medical forms of pain relief. Non-medical methods include breathing techniques, meditation, massages, showers and baths, hot or cold packs and continued movement. Maintaining a healthy lifestyle while pregnant may also help with having fewer birth complications.

Many women cope with their contractions and vaginal birth with no medical pain relief.

However, if the pain gets to be too much to handle, then you may want to explore medical pain relief. Here are the three main pain relief options for labour.

1. Nitrous Oxide and Oxygen

A gas made up of half oxygen and half nitrous oxide (laughing gas) is administered through a face mask of tube held in the mouth. The colourless and odourless gas has a calming effect and takes the edge off labour pain.

It’s important to know that it takes around 30-60 seconds of breathing for the gas to build up in your bloodstream and give you the pain relief.

Pros of Using Gas for Pain Relief

• It’s safe for your baby and your baby doesn’t require extra monitoring while you’re using it.
• The pain relief is quick and it is easy to use.
• You are able to control it.
• Your lungs immediately clear it from your system as soon as you stop breathing it.
• You can use it while you’re in the bath or birthing pool.
• It doesn’t interfere with your contractions.

Cons of Using Gas for Pain Relief

• You may experience nausea and vomiting.
• You may become confused or disorientated.
• If you are using a face mask, it can be uncomfortable or claustrophobic.
• About 1/3 of women do not experience any pain relief using gas.
• It is a very mild painkiller. It will only take the edge off pain during contractions.
• It can dry out your mouth if you use it for an extended time.
• It can be tricky to time your breathing so that the pain relief is felt at the peak of your contractions.

2. Pethidine

Pethidine is an opiate pain relieving drug that is related to morphine and heroin. In fact, it is a synthetic version of morphine. It is usually injected directly into a muscle in the buttock but it can also be given directly into a vein. It can also help you relax as it is an anti-spasmodic drug.

The effect of pethidine normally lasts between two and four hours.

It is best administered during the first stage of labour before your cervix is fully dilated and you need to start pushing.

Pros of Using Pethidine for Pain Relief

• It is effective almost immediately.
• It can be given to you by a midwife.
• It won’t slow down your labour.
• You are able to remain in a bath or birthing pool.

Cons of Using Pethidine for Pain Relief

• One in three people will have negative experiences with opiate drugs.
• You may experience giddiness and nausea. This can be helped with an anti-metic drug to control sickness.
• It may make you feel drowsy or dizzy.
• You may become disorientated.
• There is a chance that your breathing is effected.
• It may only provide mild or even no pain relief.
• The drug crosses the placenta and may affect your baby’s breathing.
• Your baby may remain drowsy for several days, particularly if your baby is born within two hours of the drug being given to you. However, this effect can be reversed by an injection given to the baby.
• The drug may also affect your baby’s sucking reflexes and breastfeeding may be more difficult to establish. 

3. Epidural Anaesthesia

An epidural is the most effective pain relief available. They are used for vaginal births and caesarean sections. Epidurals allow the mother to stay awake and alert during her baby’s birth.

In an epidural, an anaesthetist will inject anaesthetic into the lining of the spinal cord through the back .The anaesthetic deadens the nerves that carry pain signals from the uterus and cervix to the brain.

A hollow needle is inserted into the space between the layers of tissue in your spinal column, called the epidural space. A catheter is then passed through the needle. Once the tube is in place, the needle is removed. The tube is taped up your back and over your shoulder. It takes about 20 minutes to insert and another 20 minutes once the anaesthetic has been injected before it starts to work.

In Australia, most hospitals use low-dose epidurals. These contain a mixture of painkilling drugs, usually a local anaesthetic, bupivacaine, and an opioid, fentanyl.

Once your epidural is in place, it should stay in until after your baby is born and your placenta delivered.

Pros of Having an Epidural for Pain Relief

• It usually relieves pain very effectively during labour.
• It can be used at any stage of labour, but it is best at around 5-6cm dilation.
• Once the epidural is in place, top-ups can be given by an experienced midwife.
• It does not effect your mind. You should still be aware of your contractions but feel no pain.
• If you end up needing a caesarean section, it can be topped up with a stronger anaesthetic.

Cons of Having an Epidural for Pain Relief

• You have to stay in bed. If you do have sensation in your legs and feet, you may be able to shuffle around on the bed, but you won’t be able to walk around.
• It may not provide complete pain relief right away. If you’re not pain-free within 30 minutes of the epidural starting, the anaesthetist will need to adjust it or reinsert it.
• It may make you feel cold and shivery.
• You may develop itching or a fever.
• You may need to have a catheter inserted to empty your bladder.
• You may experience a drop in blood pressure.
• You and your baby will require more monitoring. Your baby’s heartbeat will be continuously monitored and your blood pressure will be taken every five minutes for 30 minutes once the epidural is started and after each top-up.
• It may slow down your labour so you are likely to need your labour speeded up with a Syntocinon drip.
• You may experience a prolonged second stage of labour.
• The use of forceps or a ventouse to help delivery is more likely.
• Your baby is more likely to end up in the posterior position.
• There is about a one in 100 chance that the epidural needle punctures the bag of fluid which surrounds the spinal cord, causing a leak of fluid. This causes a severe headache. It can be treated by taking a small amount of blood from your arm, and injecting it into your back to seal the hole made by the needle. This is done after your baby is born.
• There’s a very small risk of nerve damage. The risk is about one in 1,000 for temporary nerve damage and one in 13,000 for permanent damage.

Whatever method of pain relief you choose, it is important to be aware for what they are, what they do and any side effects that are associated with them. Make sure to talk to your health care professional about your options.

Are you ready for your labour?