Managing the pain of labour
Most women experience some pain during the process of giving birth. Some of the strategies below can be helpful in negotiating this aspect of having a baby.
Breathing and relaxation
During labour contractions, being aware of how you are breathing can help prevent feelings of panic. Focusing on breathing as slowly and deeply as you can gives a central focus, reduces feelings of panic and allows your body’s natural endorphins to be released.
Positioning
Changing positions while you are in labour will help to ensure you are as comfortable as possible.
Different positions can work best at different times and the midwife and I may suggest this to you if we think it will help.
Massage
Massage can be of great assistance for a woman in labour, providing physical comfort and relief of muscle tension, as well as communicating support from your birth partner. Variations of this are covered in antenatal classes.
Sterile water injections for relief of back pain in labour
Many women will experience back pain in labour. Sterile water injections are an effective method for the relief of back pain in labour. The procedure involves a small amount of sterile water being injected under the skin at four locations on the lower back. The injections cause a brief but intense stinging sensation, that lasts for about 30 seconds and then wears off. The process utilises the Gate theory of overwhelming nerves to reduce perception of pain. It provides effective pain relief for up to 85 per cent of women with back pain in labour and can last for up to two hours.
Warm water immersion
Warm water immersion can be very effective for pain relief during labour. Water provides support and buoyancy that enables labouring women to relax and take advantage of the weightless feeling it provides.
Nitrous oxide
Nitrous oxide gas acts as a relaxant when breathed in via a mouthpiece. Nitrous oxide is used by many women during their labour as it allows them to manage the pain of contractions as it acts and wears off quickly.
Morphine
Morphine is a narcotic drug given via injection. Morphine crosses the placenta to the baby and so it is generally used early in labour to avoid any effect on baby’s breathing after birth. It can give relief of pain for three or four hours and allows some mothers to relax and sleep early in labour.
Epidural
An epidural is an injection of local anaesthetic through a fine plastic tube which has been placed near the nerves in your spine. These nerves carry pain messages from the uterus and birth canal to the brain. When the epidural is working, the pain of labour or procedures associated with birthing may be completely or partially relieved. This procedure is performed by an anaesthetist.
You can ask for an epidural at any time during active labour. It is not usually recommended however once you are ready to commence pushing. When you have an epidural you will need to have an IV line inserted to give IV fluids as there can be changes in your blood pressure as it takes effect and having an epidural in labour means you will be recommended to also have continuous monitoring of your babies heart rate until birth.
Sometimes having an epidural can affect the frequency of contractions and mean we need to give additional medicine via the IV drip to increase them. As your sensation is diminished with an epidural if can be harder to push as effectively, so there is a chance you might need some assistance to achieve the birth of your baby such as with a vacuum cup.