Pain Relief in Labor
When you are pregnant, you will likely be reading up and learning all there is to know about pregnancy and childbirth.
It can be a frightening time if this is your first pregnancy, but hey it also the most wondrous experience you will ever have in your life. Pain relief in labor is something you need to know about.
You may have read about things that can go wrong, but while it is good to be aware of them, don't dwell on those things. The vast majority of women experience a perfectly normal pregnancy and delivery.
The actual childbirth is what scares us most, so in this article we are going to be looking at the different methods of pain relief in labor that are available.
If you understand what they are, and how they work, it will give you a better idea of what you want when you go into labor.
All of the following should be available to you, perhaps with the exception of the epidural which requires the presence of an anaesthetist.
Ask your doctor or midwife before you go into labor to find out if this method of pain relief will be available to you.
Don't be frightened by the thought of labor.
Your baby has to come out, and vaginal birth is by far the best option.
Caesarian sections (C-sections) are there for emergencies only, when baby can't be born any other way, or has to come out in a hurry due to fetal distress.
I have heard many young women specifically requesting a Caesarian because it seems like a less painful option than natural childbirth, but trust me it isn't.
The only difference is the pain comes later and lasts for longer.
A Caesarian Section is a major operation that can affect your child-bearing capabilities in the future and should certainly not be considered a normal birthing option.
If you ever get the chance to visit a post-natal ward among women who have just given birth, you will see that the ones walking slowly and holding their bellies in obvious pain are the mums who had to have a C-section.
The other mums are the ones who are running around looking a picture of health of happiness. Let that be you, having just gone through a natural childbirth.
Childbirth is painful. You will be offered pain relief to help you cope. Read down to see what pain relief in labor is on offer and how they work.
You really do leave your dignity behind when you have a baby! This video is beautiful.
Entonox (gas and air)
Gas and Air (Entonox)
Gas and Air (Entonox) is a mix of nitrous oxide (laughing gas) and oxygen.
Gas and air is good for a while, it can even make you laugh. Draw in too much and it can make you vomit as you feel all woozy. It comes with a face mask or breathing tube, and you just suck on it as the pain during a contraction intensifies.
It works by lifting your head out of the pain. It really does – you can go for a float round the labor ward when in reality you are still stuck on your bed. It’s nice and up to a point, it works.
You often think of gas and air as being the milder form of pain relief, but it works surprisingly well. Even better, there is no after-effect. It does not seem to affect baby in the slightest. Remember that when you are in labor, just as during pregnancy, everything you take in passed through the umbilical cord to the baby.
I myself have given birth using only gas and air for pain relief, and while I can't say it was less painful, I can say I didn't care so much about the pain, which, don't forget, stops as soon as baby is delivered. You may experience mild cramping when the afterbirth comes away but that is it. The hospital may offer you gas and air at that time too. Take it, not for the pain relief, just for the good feeling it gives you!
Gas and air wears off within a couple of minutes. It is a very short-acting drug, but one which you have complete control over. You have the entonox bottle at your bedside, and the mask in your hand to breathe through as you wish.
As I said above, you will quickly learn when you have taken to much as you will want to vomit. That too passes and you can quickly learn what is a good dose for you.
TENS Machine in Action
TENS machine at Amazon
Mum can find whatever position is most comfortable with a TENS machine
A TENS (transcutaneous electrical nerve system) machine is an electrical appliance and works by sending electrical impulses into your lower back. The idea is to fool the nerve impulses in your body by blocking the pain receptors on their journey up your synapses to the brain. The feeling is like loads of little needles and pins and while you are thinking about them, trying to figure out if they are painful or not, you really don’t feel how severe your labor pains have become, so in a sense it does work and works very well. But it is a strange feeling to be wearing one of them. There is control for you to increase these impulses if you start to feel the real pain of labor, but it is fair to say that on full strength it is, in itself, quite painful and definitely annoying.
Of course that is another thing, as birth approaches you enter a phase called transition. You will know you are going into transition because quite often, you are annoyed with everything and everyone around you. You may well tell your partner to clear off and not come back, and you snap at your carers too. Don’t worry about it if you feel like this – the midwives know well the signs and symptoms of transition and may at this point make arrangement to move you into a birthing room.
I would certainly recommend a TENS machine for the earlier parts of labor. I used one once and it certainly controlled my pain right through to transition which is excellent. Once I hit transition, I wanted the TENS machine OFF, right now, before I ripped it off and threw it at someone!
There is no drug usage, and nothing that can cross the placenta to your baby, and after giving birth you are free to get up out of bed and go for a bath or whatever, as there are no drugs in your system that need to wear off first. For those reasons alone, a TENS machines is excellent for pain relief in labor.
Morphine and Pethidine for Pain Relief
Morphine and Pethidine for Pain Relief in Labor
Morphine and pethidine are both controlled drugs used for pain relief. In fact, morphine is the strongest painkiller known to man, which if you are reading this while pregnant with your first child should give you some idea of how severe the pains are likely to become.
They are delivered to you by intra-muscular injection.
Don't worry about feeling frightened of needles. By the time you are in so much pain that you feel you need something 'a bit stronger', you won't be worried by a something so insignificant as a needle.
Both morphine and pethidine cross the placental barrier, so baby may be born a bit sleepier than normal but should otherwise be fine.
Unless you are an addict who has regularly been taking strong drugs throughout your pregnancy, baby should suffer from no lasting effects from an injection or two during labor.
I don’t recommend either simply because they remove your ability to cope with them pain, instead of taking it away.
The pain is dulled but so is your coping mechanism. When you hear a woman screaming in labor, chances are she has been given one of those drugs, and not that the pain is that bad.
Trust me I have given birth with and without this form of pain relief, and I’d prefer do do without. In my opinion, Entonox and TENS are both pretty effective, but the best of all is the epidural.
Spinal and Epidural Anaesthesia
where an epidural is inserted
Part of Body Number by Epidural
You can only have an epidural if an anaesthetist in on duty in the hospital at the time. He is the only one qualified to apply one. It involves injecting an anaesthetic fluid directly into your spinal column, effectively paralysing your lower body. It stops all pain completely, but does not stop labor, as you can still see your contractions happening.
You can now no longer get up and walk around as you have lost the use of your legs, and can’t go to the toilet as needed. In fact, you don’t know when you need to go either.
However it wears off in a few short hours.
Ideally you want an epidural to be administered when you still have hours to go, so that it has worn off a little by the time you come to give birth. This will help you push when the time has come.
However, even if your epidural is still working perfectly (and during labor it can be 'topped up' if it starts to wear off, without the need for another injection) you can still give birth normally even if you don't feel the 'urge to push' that is normally present at that stage. Just push when the midwife tells you to. They used to tell you in textbooks that it is a bit like the bearing down sensation of trying to pass a constipated or large stool. There may be a passing similarity but it is that pushing mechanisn that you will be using.
If your epidural has worn off a little, your body may help you by letting you feel the 'urge to push' which it does all by itself within any conscious input from you. You can help by taking deep breaths between pushes so that you can put your all behind the push.
The downside of an epidural is that after you have given birth, you will find yourself confined to bed until the drug has worn off completely. Believe me, you are on a high after successfully giving birth. You want to cuddle the baby for hours, or gaze down at his little face, while all he wants to do is sleep. If the midwives put your baby in a cot beside your bed, you will not be able to manoeuvre yourself to lift him up and put him back safely.
The other risky thing with epidurals is that they can go wrong. Injecting anything into your spinal column is dangerous, and can lead to permanent paralysis. That is why it is a highly trained specialist, the anaesthetist, who is the only person qualified to insert one. You will be rolled onto your side in order for him to insert the needle, and it is vitally important that you DO NOT MOVE during this time. This can be difficult if you are experiencing contractions, but the anaesthetist will stop what he is doing until the contraction has passed.
If you move while the needle is being inserted, the needle could go into the wrong place, resulting in paralysis. This is rare however, so don't overly worry about it in advance.
You will want a bath, preferably a bath filled with natural healing sea salts so soothe the tender area down below, but you will have to wait on the epidural wearing off and the midwives telling you that it is safe for you to get up.
Despite the downsides of epidurals, the instant pain relief received when the drug is administered is fantastic, and certainly an option to be considered.
At last it's all over! Childbirth
Epidural Greatest Thing Ever
If you are planning on breastfeeding baby, the first few minutes after birth is an excellent time to get him started. However, if you are feeling too exhausted, don't worry about it, you can feed baby later with no ill effects on your breastfeeding plans.
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