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Pain Relief Options

PAIN RELIEF OPTIONS SELF HELP TECHNIQUES

Understanding the pain 
Pain usually means something is wrong or is related to a negative experience such as trauma or injury. The pain in labour however is a positive pain, a pain with a purpose, it is bringing you your baby. The pain in labour gives you feedback about your labour. The stronger the contractions the nearer you are to having the baby.

Relaxation
The physical stress of pregnancy and labour causes women to produce endorphins – a natural pain reliever. These endorphins help to reduce physical pain and give a sense of well-being and can make you feel tired.

Being distressed releases adrenaline that overrides the effects of endorphins and oxytocin the hormone that causes contractions.

Therefore relaxation is a major key to coping with the pain of labour, as it aids the natural endorphin production.

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Floral Arrangement 2

5 KEY WAYS TO AID RELAXATION

1. Sight – dimmed lights, familiar objects, photographs

2. Hearing – music, relaxation tapes, comforting words

3. Smell – aromatherapy oils, flowers

4. Taste – barley sugars, water, peppermints

5. Touch – massage, hand holding, positioning

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Positions of Labour
During a contraction STOP – PROP – FLOP. Stop where you are, prop yourself so you are comfortable and supported, then relax and breathe with the contraction.

Breathing
When in pain, we often hold our breath. Remember to breathe during contractions, to give yourself and your baby a good oxygen supply. Concentrate on the air flowing in and out of your lungs. Breathing is in itself a pain relief.

Vocalisation
It can be helpful to vocalise your pain – moan, sigh, swear, shout. Noise is a natural response to extreme physical exertion, let your voice work for you and let go.

Positive Affirmations
Prepare yourself prior to labour with positive affirmations – be confident in your ability to cope. Repeat these affirmations during labour.

Water
A spa, bath, or shower provides buoyancy and support of the abdominal wall. The tactile effect of a shower or spa can help reduce the pain.

Rest Periods
Anticipate and enjoy the rests between contractions. They are longer than the contractions. Do some deep breathing, relax and re-energise.

Heat and Cold
Many women find that flannels, hot water bottles or wheat bags are very soothing in labour. Especially useful for back pain. A cold flannel wipe between contractions is also helpful.

Basic Bodily Functions
Keep well hydrated in labour (a least a sip of water after each contraction). The uterus is a big muscle and muscles don't work as effectively if you are dehydrated. Your baby and bladder compete for space, so remember to pass urine 1-2 hourly during your labour to help let your baby's head come down.

Movement
Be as upright as possible – gravity and pressure of baby's head on the cervix can help speed up dilatation. Rocking, swaying and walking on the spot is comforting and may help baby descend into the pelvis.

Other Alternatives
Aromatherapy, acupuncture, and homeopathy can all be useful. Discuss with a registered practitioner and your Lead Maternity Carer before labour.

Transcutaneous Electrical Nerve Stimulation (TENS)
This is a small battery powered stimulator with 4 electrodes applied to the women's back. Those electrodes deliver pulses to the skin felt as a tingling or tapping sensation. TENS stimulates the production of endorphins and the sensation or the pulses is transmitted to the brain faster than the pain sensation.

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MEDICAL PAIN RELIEF

Gas and Air (Entonox)
A mixture of nitrous oxide and oxygen given via a mouth piece, can provide efficient, shortacting pain relief. It can make your mouth feel dry - sips of water may help.

You may also feel dizzy and faint when you first begin to use it but this usually passes quickly. The mouth piece is held by the woman and gas is self-administered by inhaling through the mouth piece from the beginning of the contraction until the pain is beginning to subside.

It can take the edge off the pain, it doesn't take the pain away completely. It also reinforces rhythmic breathing.

Pethidine
Pethidine can be a very effective, rapidly acting narcotic form of pain relief in labour. It makes you relax and sleep between the contractions and makes you less aware of the intensity of the contractions.

It may be given with an anti-nausea medication as it can make you feel nauseous. Pethidine is most often given intramuscularly but can sometimes be given intravenously in small amounts.

Pethidine crosses the placenta to the baby. It can depress the breathing response of the baby at delivery and the baby may need narcan (an antidote) to reverse this effect. It can cause drowsiness in the baby, which may affect his/her suck reflex and you may require extra support with breastfeeding for the first few days. It can take the baby 2-3 days for the effect of the pethidine to wear off the baby.

Epidural
An anaesthetist injects a small plastic tube into the epidural space in your back and injects of a mixture of local anaesthetic and fentanyl (a narcotic). The tube is left taped into your back and is hooked up to a pump that administers a continuous dose of the medication until you have had the baby.

It makes you numb from your umbilicus to your toes. It takes approximately 20 minutes to have a good affect. You are given the smallest possible dose of the medication mixture to make you comfortable and to allow you to still feel pressure or even a little pain with the contractions.

The possible problems caused by an epidural are a fall in blood pressure, (an intravenous line is put in prior to the epidural to reduce this affect), numb legs and occasionally a headache, backache or infection. A catheter is put into your bladder as you cannot feel that your bladder if full. You may also need assistance with directing your push. An assisted delivery with forceps or a ventouse is more likely as you cannot feel the urge to push.

Signed consent is required prior to this procedure.

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