No matter how much you prepare, it is hard to know how you will actually feel when you are in labour, so it is a good idea to think about your options beforehand. Labour pain is very subjective, meaning that each woman will experience and cope with pain differently from the next woman. Labour pain and contractions will also change in sensation, frequency and duration, so you may consider trying a variety of different methods of pain relief to help you work with or through your labour.

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Breathing and relaxation techniques

 

Breathing and relaxation techniques help you cope with pain and keep you calm and relaxed.

Pain often feels worse when you're tense and anxious. When you’re relaxed, your body releases its own hormone-like pain relievers called endorphins.

TENS (transcutaneous electrical nerve stimulation) machines

  • are safe to use and don’t affect your baby
  • works best in early labour
  • do you use a TENS machine before 37 weeks

To use a TENS machine:

  • you place pads onto specific areas on your lower back
  • the machine runs a gentle electric current through the pads - this gives you a tingling feeling which eases the pain
  • you use a handset to control the TENS machine and adjust the current as your contractions get stronger

If you want to use TENS, ask your midwife about where you can hire a machine.

Complementary therapies

Some midwives in Tayside are trained to use aromatherapy in labour. If you want to use acupuncture or acupressure during labour you can. 

Hypnobirthing

Hypnobirthing is a mixture of:

  • visualisation
  • relaxation
  • mindfulness
  • deep–breathing techniques

It doesn’t work for everyone, but can help you focus on your body and the birth of your baby.

You will need to prepare for this throughout your pregnancy.

Gas and air

 

Gas and air (also known as Entonox) helps to ease the pain of contractions, and lasts as long as you keep breathing it in. It does not take the pain away but helps you to cope with it better.

Gas and air is a mix of 2 gases – nitrous oxide and oxygen. 

How it works

  • comes with a tube and a mouthpiece that you breathe through when you need it. For it to work well you need to breath it in as soon as you feel a contraction starting
  • it starts to work within about 15 to 20 seconds after you first breathe it in - you keep breathing it until the contraction pain starts to ease

Pros

  • is safe to use throughout labour - there’s no danger of having too much
  • leaves your body quickly
  • won’t stop you using other pain relief (can be used in the birthing pool)
  • won’t affect your baby as very little will reach them

Cons

  • can make some women feel sick when they use it
  • doesn’t give long-lasting pain relief

 

Diamorphine

 

Diamorphine is a strong, effective painkiller, known as an Opioid.

You can have diamorphine wherever you’re giving birth, but if you are in the pool you will need to come out as it can make you sleepy. 

How it works

Diamorphine is given as an injection into a big muscle, such as your buttock or thigh, and:

  • takes about 15-20 minutes to work
  • last for between 2 and 4 hours

Pros

  • Diamorphnie works quickly and last for a few hours.

Cons

  • can make you feel sleepy and not in control
  • can make you feel sick, so an anti-sickness medicine is usually given at the same time
  • can affect your baby’s breathing when they’re born
  • can make your baby sleepier and less interested in feeding for the first 24 hours

Baby's breathing

Diamorphine can affect your baby’s breathing when they’re born, particularly if you have it too close to the birth. If you’re about to give birth your midwife or doctor might suggest you don’t have it for this reason.

Sleeping and feeding

Diamorphine can make your baby sleepier and less interested in feeding for the first 24 hours. You may need to wake them to feed. You will be supported during this time by your midwife.

 

Epidural

 

An epidural is a small, thin tube inserted into your back to deliver pain-relieving medicine.

An epidural will take away the pain of the contractions

An epidural can work well but it’s also the most complicated pain relief and needs to be put in by an Anaesthetist. That means you can only have an epidural in the Labour Suite.

How it works

The epidural is inserted into your back using a needle - you will be given a local anaesthetic into your back first. When the medicine is put through the tube it numbs the feeling in the area around your spinal nerve - the epidural space. This blocks the feeling of pain in your lower body, but you can still feel:

  • someone or something touching you
  • the pressure as your baby's being born

You’ll also have:

  • a drip so that you can have fluids and other medicines if you need them
  • your blood pressure checked regularly once the epidural is in
  • your baby’s heartbeat monitored continuously

Who can have an epidural?

Most women can have an epidural. But you may not be able to have one if:

  • you've health conditions such as clotting issues
  • you’ve had some kinds of back operation

Your midwife or doctor might suggest an epidural if:

  • you've had a long labour
  • you’re having twins
  • you've high blood pressure or other medical issues

Talk to your midwife about speaking to an Anaesthetist if you want to find out more.

Pros

  • is the best form of analgesia available
  • doesn’t make you sleepy
  • takes away the pain of contractions and may take away the pain of birth too
  • is safe for your baby and you can breastfeed as normal when they arrive
  • can usually be topped up to give pain relief if you need a ventouse or forceps delivery, or caesarean section

More about epidurals and anaesthetics in labour

Cons

  • can cause your legs to feel numb or heavy which can make it harder to push
  • can make it difficult for you to pass urine on your own, so your midwife may need to put a tube called a catheter into your bladder
  • can cause bad headaches for a few days or weeks after the birth in about 1 in 100 cases - this can usually be treated with painkillers and fluids but sometimes needs special treatment
  • can cause a long-lasting nerve injury, such as a numb patch on your leg or a slightly weak leg. This is very rare.
  • can cause other side effects, such as itching and some soreness in the place where the epidural goes into your back
  • About 1 in 10 epidurals don’t work perfectly at first. If yours doesn’t work, you may need to have it adjusted or replaced.

Assisted delivery

If you’ve had an epidural you’re more likely to need an assisted delivery with forceps or ventouse. This is because:

  • you may not feel the urge to push as strongly
  • you’re less likely to be able to push well