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Pain relief in labour
This page provides information about pain relief of labour. Further information about the types of pain relief available at each hospital will be provided by the staff looking after you.
Obstetric anaesthetists association
What will labour feel like?
Towards the end of pregnancy you may notice Braxton-Hicks contractions (your uterus tightening from time to time). When labour starts these tightenings become regular and much stronger. This may cause pain that at first feels like strong period pain, but gets more severe as labour progresses. The amount of pain varies. Your first labour is usually the longest and hardest. Sometimes it is necessary to start labour artificially (induction of labour) or to stimulate it if progress is slow, and this may make it seem more painful. Over 90 per cent of women find they need some sort of pain relief during labour.
Preparing for labour: Parentcraft classes
These classes aim to teach you about pregnancy, labour and caring for your baby. They will tell you what to expect when you go in to labour, what procedures may be required and the reasons for them. Understanding what may happen during labour will make you feel less anxious. It is also a good plan to visit the hospital where you plan to have your baby so that you become familiar with the surroundings.
What methods of pain relief are available?
The presence of a companion, or birthing partner, during your labour can be invaluable. There are several other ways of helping you cope with pain. It can be difficult to know beforehand what sort of pain relief is best for you and when to ask for it. Methods include:
Transcutaneous Electrical Nerve Stimulation (TENS):
- A gentle electric current is passed through four flat pads stuck to your back. This creates a tingling feeling and probably works by stimulating the production of your own painkillers within your spine. You can control the strength of the current yourself.
- These small, battery operated machines can be hired for a month at around the time of delivery from several specialist companies, Boots or Superdrug stores on the high street.
- TENS is often helpful at the beginning of labour, to take the 'edge' off your pain.
- It can be started at home before you come to hospital.
- It is proven to be safe to use, with no side effects to you or your baby.
TENS can be safely used at the same time as entonox, pethidine or other natural pain killers.
Entonox (gas and air):
- This is a mixture of 50 per cent oxygen with 50 per cent nitrous oxide and is also known as 'gas and air'.
- You breathe this through a mask or mouthpiece.
- It is simple, quick to act and wears off rapidly.
- It often makes you feel light headed or nauseous for a short time.
- You need to start breathing the gas when you first feel the contraction so you get the full effect when your contraction reaches its peak.
- It does not harm your baby.
- It does not take the pain away completely, but helps to control it.
- It can be used at any time during labour.
Pethidine:
- This is an injection given by the midwife to make you more relaxed about the pain from the contractions.
- It may make you drowsy.
- It may make your baby drowsy after it has been born and your baby may be slower to start breastfeeding.
- It is an option to consider at the beginning of labour.
Epidurals:
- A small plastic tube (epidural catheter) is inserted into your back through a needle (the needle is then removed, but the plastic tube remains in place).
- Epidurals are only inserted by anaesthetists.
- Drugs are injected through the epidural catheter as necessary, usually every one to two hours.
- After injection of the drug your blood pressure will be monitored for 20 minutes.
- Your baby's heart rate may be monitored continuously.
- Most women with an epidural can walk a few yards with support (for example, to the toilet) and adopt their preferred position for delivery.
- Epidurals cause little effect on your baby.
- Recent audits suggest that modern epidurals do not increase the risk of needing forceps delivery or Caesarean section.
- If you have a complicated or long labour we may recommend that you choose an epidural as in these circumstances it is likely to benefit both you and your baby.
- Epidurals carry a small risk of causing a severe headache (less than 1 in 200).
- Sometimes you may not be able to tell when your bladder is full and the midwife may encourage you to pass urine regularly or you may need to be catheterised.
- Epidurals occasionally do not work properly and need to be replaced. But they are usually the most effective method of removing pain in labour.
- They may not be suitable for some people with certain medical conditions, such as inherited bleeding problems. The anaesthetist can provide you with more information if you need it.
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