Pain Relief in Childbirth

There is a preoccupation with pain and the birthing mother. But pain is a subjective notion and each individual experiences pain differently. Pain during labour can come from a variety of sources. Emotional sources can be fear of the unknown, or a lack of knowledge and experience. Pain can be influenced by an individual’s beliefs, culture, ideas, fears and feelings and past experiences. Functional sources of pain can be uterine contractions, cervical dilatation, progress and position of the baby, position, and medical intervention.

Pain is a given in child birth, but there are also ways to manage the pain of labour and birth. Regardless of what type of birth you are seeking, there are strategies to help you get though. Your health care provider can suggest what pain relief in childbirth is best for you.

Options include:

Natural pain relief during labour

  1. Water – Water can be used for pain relief regardless of having a water birth or not.  Immersion in water can reduce the intensity of contractions without affecting progression of labour, mother or the baby. A warm shower will also assist with pain relief if you are in a hospital with no bath or birthing pool. One of the advantages to a shower is that you can remain upright and direct the shower head at the location of your pain.
  2. Relaxation strategies – Calm birth  and Hypno-birthing while different, are based on the similar principles. The philosophies are based on the belief that pregnancy, labour and preparing for childbirth are normal and natural events for a woman. Both use the tools of relaxation, breathing and creative visualisation, and trance to manage the pain of labour.
  3. Massage – Massage stimulates the production of endorphins which are a natural pain killer and a mood enhancer. This method can be performed by your doula or your partner. Massage can also reduce the anxiety some women experience in child birth. message given by the mother’s partner can be emotionally comforting, as well as providing relief.
  4. TENS Machine – Using a TENS machine applies low voltage electric impulses, to provide some pain relief during labour. The impulses send a signal to the brain where they compete with pain impulses from the uterus, helping to obstruct the pain. TENS stands for transcutaneous electrical nerve stimulation.

Pharmacological pain relief during childbirth

There are some side-effects associated with pharmaceutical pain relief, which are detailed below:

  • Nitrous oxide – also known as ‘gas’ or ‘laughing gas’ it is combined with oxygen and given through a face mask. The woman breathes from the mask as soon as contraction begins and releases the mask as the contraction begins to subside. This method helps the mother by decreasing the intensity of pain and allows her direct control. This method may not work for some women and may cause nausea, vomiting, confusion and disorientation.
  • Pethidine – This drug comes under the morphine family. It is an analgesic usually administered by intramuscular injection into the buttock. The effects from pethidine can last from two to four hours. However, it can cause disorientation and nausea for the mother. Pethidine may be administered with anti-vomiting drugs at the same time. In rare cases it can cause respiratory depression to both mother and the baby.
  • Epidural – also referred to as “epidural block”, is a needle inserted in to your back – between your vertebrae, and numbs the lower part of your body. The skin on your back will be disinfected and local anaesthetic is given to aid the insertion of the needle and catheter. The needle is then removed, leaving the catheter in place to deliver the drug that numbs the area. You remain awake and alert, but will have no sensation from the waist down. It is a fast-acting analgesic and can be used during forceps or vacuum extraction during a vaginal birth, and a caesarean delivery.
  • Spinal block – The method of administration is the same with an epidural but it can be given while you sit or lie on your side in bed. It also brings pain relief and is fast-acting. However, it only lasts from one to two hours.
  • General anesthesia – This method put you to sleep and is generally only used in an emergency. You feel no pain at all under a general anaesthetic but your recovery from childbirth is longer.

The choice of pain relief is yours. Not all methods are offered in all settings. Talk to your doctor about the options and don’t be reluctant to ask for pain relief if you need it.

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