Pregnancy and childbirth: Pain relief during labour
Pain during labour is what a lot pregnant women dread most. But with a range of pain- relief options, it's not all doom and gloom. Sarah O'Buachalla, staff midwife at Mount Carmel Maternity Hospital, discusses the options
WHEN it comes to pain relief during labour, it's important that you find out as much as possible about the options available to you in your home or hospital of choice. Remember that your midwife is there to support you in whatever decisions you make and she can also help guide you if you need a hand in making those decisions.
A relaxed atmosphere is important. Make it as calm as possible. Comfortable furniture is ideal along with maximum privacy. Don't forget your music, be it a small radio or ipod.
Make sure you pick a supportive birthing partner. Maybe it will be your husband, partner, mother, sister or friend. Just ensure that it is someone who will be of good support to you.
Once labour begins, you might find that you become restless. Changing positions in labour helps to comfort and reduce pain. It also helps to change the shape and size of the pelvis, which in turn helps the baby's head to move into a more optimum position for birth.
Birthing balls are a great comfort tool for labour. They can help support you in various positions. Sitting on the ball with legs firmly fixed to the floor and legs approximately 90 degrees apart can open the pelvis and aid the descent of the baby's head.
You can use it to rock through your contractions, by swaying from side to side on the ball. If normal chairs or seats are uncomfortable, then sitting on the birthing ball can be more comfortable.
Placing the ball on the floor, with a pillow under your knees as you lean forward onto the ball, can again take any pressure off your back during labour.
If you fancy a nice soak during your labour, then a nice warm shower or bath could be your answer. Make sure the water is nice and hot at about 35– 37 degrees Celsius. Hot water helps to aid relaxation and reduce the pain of contractions. This helps reduce stress hormones in the body, which can slow progress in labour. Water also makes women more buoyant, giving them the feeling of weightlessness.
TENS means Transcutaneous Electrical Nerve Stimulation. It is a gentle electrical current that passes through four flat pads attached to your back. It creates a tingling sensation and releases endorphins, your body's natural pain relieving hormones. It is often helpful in early labour and also right through the duration. You can increase or decrease the strength of the current yourself as the contractions get stronger by using the controls and the booster button.
Pethadine is a drug used for pain relief in labour. It is given by injection into the buttock. It takes approximately 20 minutes to work and lasts for up to two to four hours. Pethadine injections seem to work best for women in early labour. If you are feeling anxious it can help you to relax and often makes you feel a little sleepy.
Entonox ( gas and air):
Better known as the laughing gas, Entonox is a mixture of oxygen and nitrous oxide. It is a colourless and odourless gas. It does not get rid of the pain, but can help to relieve it and make it easier to manage. You can control the flow of gas yourself by taking deep breaths in and out through a mouthpiece or mask as the contraction begins and removing the mouthpiece from your mouth once the contraction is over. It may make you feel a little nauseated, dizzy or lightheaded, but this does not last long once the gas has left your system.
Epidural is a regional anaesthetic that blocks pain in a particular region of the body. The goal of an epidural is to provide pain relief rather than the total lack of feeling. Your epidural will be given to you by an anaesthetist.
Firstly you will need a drip to give you fluids, to ensure that your blood pressure does not go low. You will then be asked to lie down or curl up to make sure you are in the correct position. Now your back will be cleaned with a solution – be ready because the solution will be freezing cold! – then a little scratch of some local anaesthetic to numb the area, so you should not feel much.
A very thin plastic tube is placed into your back, close to the nerves that are carrying the pain to the uterus. This tube is then secured in place to stop it from being disturbed.
The epidural drugs are then given through the small plastic tube and it takes approximately 15 minutes to become totally pain- free. You will not be able to walk around once the epidural is in place, so you will need a tube in you bladder ( urinary catheter) to keep your bladder empty. The epidural drugs might make your skin itch, this is normal, so go ahead and have a good scratch!
Sarah O'Buachalla, ( RGN, RM, BSC Nursing) is a staff midwife at Mount Carmel Maternity Hospital, Churchtown, Dublin 14. For more information about maternity packages at Mount Carmel, contact Bairbre Keane or Sally-anne Doddy, t: 01 4063401, e: maternity@ mcm. ie
Mother & Babies