Pain-relief for labour: What are your options?

Choosing the right pain relief should ensure a smooth delivery for you. We look at the methods available in Singapore

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From your first positive test, to discovering your baby’s gender, your pregnancy is an event-filled journey that will ultimately culminate in labour and the birth of your little one.

No two ways about it ― labour is going to be painful for most women. This is caused by the contractions of your uterus, the pressure your about-to-arrive baby is putting on your cervix, and the stretching of your birth canal and vagina.

In addition, labour can be exhausting. You might start with mild contractions, seven minutes apart, but this can progress quickly into strong waves of pain, with less time for you to relax in between.

“Know yourself, and know that you don’t need to suffer.”

While labour is different for every woman, it’s important to learn about all the ways you can ease your pain. SmartParents expert Dr Christopher Chong, a consultant obstetrician, and gynaecologist at Gleneagles Hospital, advises his patients to “know yourself, and know that you don’t need to suffer”.

“I always joke with my patients that if they were to kick and scratch the gynae when they are in pain, then yes, please use the epidural,” he laughs. He also adds that pain relief can help the patient to relax and help the cervix to open faster. “I If the labour is going to be long, it’s important to have no pain, so that the patient can rest and have enough energy to push the baby out.”

Here are some common pain-relief options available in Singapore.

Entonox

Also known as laughing gas, this is a mix of oxygen and nitrous oxide gas. While this won’t remove all the pain, it can make it more bearable. The labouring mum will use it herself when she needs it, and should be inhaled 30 seconds before each contraction for maximum effect, Dr Chong notes. Nausea and “feeling high” are some common side effects.

Says Katherine Tan, mum to Denise, 2, “The gas was useful because it helped me to control my breathing when the contractions came.”

Pethidine (An intra-muscular injection)

This analgesic is administered via an injection to the buttocks ― the dosage is dependent on the mother’s weight. It dulls the response of pain fibres in the mum’s body.

Pethidine can potentially cause the foetal heartrate to drop, or the foetus can become sleepy. Dr Chong adds that pethidine should preferably not be given within four hours of delivery as it may “cross over to the foetus, making him sleepy and retarding his breathing at birth”. In some cases, an antidote may need to be injected into the baby. Common side effects for the mum include nausea, vomiting and sleepiness.

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Epidural anaesthesia

Epidurals are commonly used these days ― you should use it as soon as labour starts, or before labour is induced (for any medical reasons). “Used correctly and if it is working well, the patient should have no pain at all,” says Dr Chong. Another advantage is that should you need an emergency C-section, the same epidural can be used.

As with other pain-relief methods, there are side effects. Epidural can potentially cause the mother’s blood pressure to drop. Other side effects include backache, a headache and paralysis of the lower limbs (this is rare). Epidural may also cause a sudden drop in the foetal heartrate, but it will usually return to normal without needing medical intervention.

Mobile anaesthesia

Similar to an epidural anaesthesia, it offers excellent pain relief, but also allows you to keep some feeling in your legs. You may be able to move around ― being upright can help labour progress more smoothly as “gravity does help in speeding up labour,” Dr Chong points out. Although this form of pain relief is available in Singapore, it’s rarely used. “It depends on the hospital’s policy, the patient’s suitability and the anaesthetist’s skill and preference,” Dr Chong says.

What is lacking in mobile epidural, though, is the monitoring of the foetus’ well-being. Dr Chong explains, “While the patient is normally hooked onto a CTG machine to monitor the contractions and the baby’s heartbeat, if she is walking about, the monitor on her abdomen can shift”. In addition, if foetal distress were to occur (and this can happen very suddenly), the patients will need to be back in time to call for help.

A warm bath can relax the tension in your muscles and even speed up labour.

If you prefer to go through labour free of drugs, here are other ways to reduce your pain!

TENS machine (nerve stimulation)

This device ― meaning Transcutaneous Electrical Nerve Stimulation ― delivers small pulses of electrical currents to reduce your pain. The currents block the pain signals as they travel through the nerves to your brain, and stimulates the production of endorphins, your natural pain-relieving hormones. It’s generally safe, but do check with your doctor.

Other natural pain-relief methods

Rhythmic breathing

You might have been taught some breathing techniques during your prenatal class. Focusing on your breathing (deeply in a slow rhythm, or taking quick rhythmic breaths) can help you take your mind off the pain.

A warm bath or shower

If you are in the early stages of labour, a warm bath can relax the tension in your muscles and even speed up labour.

Touch

Get your husband to hold your hand, stroke your hair or massage your legs lightly. This should reassure you and help you feel more comfortable, which helps soothe the pain.

Keep moving

Walk around, lean over a large cushion or bean bag, or sway from side to side. Some positions will be more comfortable than others.

Photos: iStock

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