Managing your pain
There are lots of options for pain relief in labour. Every person’s labour is different and there is no right or wrong pain relief choice. You might use some, you might use many or you might use none.
It is worth knowing what is available to help you to make informed choices during labour.
It’s also helpful for your birth partner to know about the different options, as well as how they can support you. Not all methods are available at home or in midwife-led units.
The main options available are:
- Water immersion (available for home, midwife-led unit and Obstetric-led unit)
- Transcutaneous Electrical Nerve Stimulation (TENS) (suitable for home, midwife-led unit and Obstetric-led unit)
- Hypnobirthing (suitable for home, midwife-led unit and Obstetric-led unit)
- Gas and air (Entonox) (suitable for home, midwife-led unit and Obstetric-led unit)
- Injections of analgesia (painkiller) medicine (available in Obstetric-led unit)
- Epidural (available in Obstetric led unit)
- Staying mobile, soothing massage and aromatherapy can also be beneficial.
Staying mobile
Moving around can help you to ease the discomfort and helps to keep your labour going. Don’t wear yourself out; you need to save energy for the birth.
Massage
A massage from your birth partner may help to soothe you during contractions, especially if you have back pain. It also helps to release Oxytocin (the ‘love’ hormone).
Aromatherapy
Aromatherapy may help to promote a positive state of mind and body health, making you feel calmer in labour.
Self-hypnosis/ hypnobirthing
This uses relaxation and breathing methods aiming to achieve a calm birth. You would need to do a course from a reputable provider ahead of the birth.
TENS
TENS is a small machine that transmits electrical impulses onto your back to block pain signals and help your body produce endorphins.
Advantages
- You can move around freely and use for as long as you want
- Can use it at home
Disadvantages
- Can’t use it in water
- Needs to be hired or bought before birth
Water
In the early stages of labour, you may find it soothing to have a warm bath at home.
We have birthing pools in all our maternity units. The pools can be used for pain relief and birth itself.
Advantages
- Warm water is soothing and calming
- Deep water allows a sense of weightlessness and soothes tension
- Helps with the normal processes of labour
- Can use Entonox whilst in the pool
- Can be used at home
Disadvantages
- Available to low-risk birth people only
Entonox (gas and air)
A mixture of oxygen and nitrous oxide gas which you breathe through a tube when needed.
Advantages
- You are in control of when you breathe it in
- Effects quickly go away so you feel yourself between contractions
- You can still move freely/use the pool
- Can be used at home with a midwife present
- No effects on baby
Disadvantages
- Some people do not like the effects of Entonox or do not find it effective
- Can make you feel very thirsty
Pethidine
An opioid injection.
Advantages
- Can help you relax and get some rest
- Can be given by a midwife so you don’t have to wait for a doctor to prescribe
- Does not slow labour down
Disadvantages
- Can make some people feel nauseated but is given with an anti-sickness medication just in case
- Not available at home
- Some women don’t like the sensation of feeling sleepy/woozy and it takes a few hours for the effects to fade
- Pethidine crosses the placental barrier. If your labour is quicker than expected your baby may be sleepy at birth and could need more support to start breathing
Epidural
A local anaesthetic delivered through a tube inserted into the space between two vertebrae in your back.
Advantages
- Aims to take away pain in labour. The pressure sensation of contractions stays so that you are still able to push when you need to.
- Does not make you feel woozy/sleepy
- ‘Low dose’ mix used at both hospitals, allows you to be more mobile. Some people can walk and empty their bladder. Allows for more mobility and position changes
- Patient controlled top-ups allow you to be in control of your labour
Disadvantages
- Can only be performed by an anaesthetist
- You will need a cannula in your hand/arm to deliver fluid (a drip) as the epidural can cause your blood pressure to drop
- Your baby will need to be monitored continuously when the epidural is first inserted in case your blood pressure drops
- You may need a catheter (tube in your bladder) if you are unable to wee
- The epidural takes around 40 minutes to insert (whilst you sit very still) and around 20 minutes to start working. Your labour might be progressing too fast for the epidural to have time to work effectively
- You are more likely to have an instrumental birth (forceps or ventouse) as you may not be able to push as effectively.
- We aim to have started an epidural within an hour of you asking for one. Most of the time we can achieve this, but due to clinical workload you may have to wait longer. If this happens, we will offer you other choices of pain relief.