Labour and giving birth: What are your pain relief options?

From epidurals to hypnotherapy, here’s our ultimate guide to tackling labour pain as well as notes on a few ways of giving birth that could make it easier.

Labour and giving birth: What are your pain relief options?


Needless to say, labour is painful for most women. Just the thought of the uterus contracting, the pressure your about-to-be-delivered bundle exerts on your cervix, and the stretching of your birth canal and vagina is enough to leave you in cold sweat.

While there are mothers who advocate the benefits of a drug-free delivery, it isn't every mum-to-be's cup of tea. So, consider these pain relief options instead...

TENS machine

A Transcutaneous Electrical Nerve Stimulation (TENS) machine sends electrical impulses through sticky pads placed at points on your lower back. This blocks pain messages as they travel through the nerves to your brain. There are many different types available, so, consult your gynae.

PROS You can hire your own unit (for instance, from Mother & Child) to use at home or bring to the hospital; few provide pain relief via this machine. It functions as a minor form of pain relief and as a distractor. You can also use it when you have early contractions at home. It’s safe for both you and baby.
CONS You need to use it from the moment you feel the first twinge and gradually increase the strength of the pulses as your contractions gain strength. We suggest practicing with it before you actually go into labour. The pulses can also get irritating with bad contractions.

Gas and air

Entonox - more commonly known as gas and air - is made up of 50 per cent nitrous oxide (NO) and 50 per cent oxygen (O2). Stored in tanks in the delivery room, you inhale it through a mouthpiece and it accumulates in your blood stream to ease pain quickly and effectively. It is the most common form of pain relief, and 50 per cent of mums find that it performs satisfactorily. It alters your state of mind so you feel less agony, rather than eliminating the pain.

PROS Inhaling through the mouthpiece gives you something to focus on. You can use it throughout your labour and it’s completely safe.
CONS Entonox can make you feel nauseous, light-headed, dizzy - even drunk. You have to start inhaling once a contraction starts, as it takes about 15 seconds to take effect. It’s also exhausting to breathe the gas and air and it can dry your mouth.

Pethidine

A morphine-like drug injected into your bottom or thigh, pethidine dulls the pain by acting on the nerve cells in your spine and brain, and lasts for two to three hours. Obstetricians tend not to use pethidine if you’re nearing delivery — it can cross the placenta and make your baby drowsy and slow to breathe or feed after the birth.

PROS Pethidine may help you to relax, which will make for an easier labour. In hospitals such as KK Women’s and Children’s Hospital, the patient can self-administer the drug by pressing a button on a device.
CONS You can become dizzy or drowsy, and pethidine is not guaranteed to get rid of the pain completely. Some people have a reaction to it and may feel like they’re out of control; another drug, naloxone, is used to reverse the effects on you and the newborn, if pethidine has crossed the placenta.

Epidural

A local anaesthetic that’s injected into your back by an anaesthetist, to numb the nerves between your spine and womb. You lose feeling from the top of your bump down to your toes. Epidural usage is becoming increasingly common. KK Hospital reports that about 40 per cent of their patients in labour opt for an epidural.

PROS More than 95 per cent of women get complete pain relief from an epidural. A technique called Patient-Controlled Epidural Analgesia (PCEA) is available at KK Hospital  you can control and top up your epidural dosage by pushing a button that connects to a pre-programmed gadget.
CONS An anaesthetist may not always be on hand to administer an epidural immediately when you really need it, and it’s a fiddly job if you’re mid-contraction. You might possibly get a bad headache from it, too.

Other alternatives

Water birth
Warm water is known to relax you, ease aches and support your body. It’s great for labour since you’ll dilate better when you’re relaxed, hastening the process. You can spend all or part of your labour semi-submerged at home or in the hospital (arrange with your gynae/hospital beforehand as there are protocols to follow), or even deliver in the wate . Entering the pool when labour is advanced or when you’re at least 5cm dilated will speed things up. Note: A pool takes time to fill, so allow up to an hour to prep it.

Hypnotherapy
Devotees maintain that you can distract your mind from the pain by using self-hypnosis techniques, which you learn in advance from a therapist. The idea is that you’ll enter a deep state of relaxation by shifting your attention away from the pain and discomfort. Anxious and easily distracted types may find it difficult to master, though. Again, see our guide to the things you can do to make labour easier.

Breathing techniques
Take deep breaths in (through the nose) and out (through the mouth), through each contraction. Prenatal classes teach you how to breathe and you can practise this throughout your pregnancy. It doesn’t remove the pain, but it does help you feel in control and gives you something to focus on to keep your mind off the pain.

Photo: INGimage

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