We all hope that we are one of those women, you know the ones; they may wince a bit as their contractions get stronger, and utter a demure ‘ouch’ when their baby emerges, but for the most part they stoically and quietly deal with giving birth whilst those around them watch in complete awe!! The reality, unfortunately for most of us is not quite as elegant or serene – and let’s be honest, if there’s one time in your life when you’re allowed to scream, yelp, curse and even moo (don’t knock it ’til you’ve tried it!!), this is it! For most of us it’s a fact: childbirth hurts! However the way that you plan on dealing with the pain is a personal choice, based on your own thresholds and the pain relief options available.
Going for a natural birth
Even if you’re planning on going for the epidural as soon as you’re booked into the Delivery Suite, there are some natural methods for coping with contractions and labour pain that may make your early stages more comfortable and for those wanting to delay any medical pain relief for as long as possible, there are some methods you might like to try…
Hypnosis, breathing and relaxation techniques
We experience pain at a greater level when we are tense or stressed, the more pain we have, the more panicked we become and so the more pain we experience… Relaxation techniques are a way of letting you gain control over your pain, breathing and meditating your way through each contraction and stopping the vicious cycle of pain related stress and anxiety.
Understanding what is happening to your body through each stage is really important, so make sure that you know why the contractions are coming, what happens as they get stronger and that with each contraction you are one step closer to meeting your baby.
Short for transcutaneous electrical nerve stimulation, a TENS machine sounds much more scary than it actually is! The machine works by attaching electrodes to your back and sending small, safe currents via a battery operated stimulator. The stimulation of more of the body’s natural painkillers (endorphins) and the reduction of the number of pain signals sent to the brain by the spinal cord result in a reduction in the level of pain that you experience through your contractions.
With no side effects for either you or your baby, TENS is a popular method of pain relief which is generally most effective in the early stages of labour. If of interest, the machines can be hired or may be supplied by the hospital – make sure you check where you can get one in plenty of time!
If you’ve ever taken a bath to help a bad back or period pains, you’ll know just how calming and soothing warm water can be. Using a birthing pool for labour works in two ways, the water not only relaxes and calms but also provides support so that it may be easier to find a comfortable position.
It’s recommended that you wait until you’re about 5cms dilated before you get into the pool as it can actually slow labour down.
A little more help required?!
There’s no need to be a hero! Pain relief is there for a reason, giving birth hurts! There are still options though, and it’s good to know what’s available….
Gas and Air (entonox)
A mixture of oxygen and nitrous oxide, gas and air won’t take the pain away completely, but it will take the edge off. You’ll be given a mouthpiece, sometimes a mask, which you can hold yourself and you decide when you need it. By breathing deeply and slowly as a contraction begins, the gas will start to work about 15 to 20 seconds later and should be hitting the spot as the contraction strengthens.
Although there are no side effects for the baby, some women do find that gas and air makes them feel light headed or a bit sick. If that happens, though, you can simply stop taking it and the symptoms will wear off quickly.
A real plus point of gas and air is that wherever you give birth, home, hospital or birthing centre, whether you’re on a bed or in a birthing pool, you can still use it.
Painkilling drugs: Pethidine, diamorphine, meptid and remifentanyl
If gas and air just isn’t enough, there are opioid drugs that can be administered by your midwife to help with the pain; pethidine, diamorphine and meptid. Some hospitals also offer remifentanyl, a strong short-acting painkiller which is administered using a drip that you can control yourself using a machine.
Pethidine is the the most commonly used medication, and is given via an intramuscular injection into your thigh or buttock. The good news about pethidine and similar drugs is that their effects last for a few hours, although if you suffer from side effects (drowsiness, forgetfulness and nausea) this may be a negative. They don’t slow labour down and may help you avoid an epidural. It’s a good idea to ask for half a dose first of all to see how the drug affects you, as it can be harder to push if the effects haven’t worn off towards the end of labour.
A big negative with this form of pain relief is that it may have an effect on your baby. Opioids pass through to the baby and can occasionally make them slower to breathe at birth, especially if your labour speeds up and the baby is born within two hours of you having the drug. You may also find that your baby is sleepy for several days after the birth, making breastfeeding harder to establish.
You may find that you don’t have access to pethidine or diamorphine if you are having a home birth and there may be some restrictions if you’re using a birthing pool. It’s a good idea to check with your midwife to see what options are available for the type of birth that you’ve requested.
This is the big one! An epidural is an anaesthetic that is injected in the space between the vertebrae in your back. This specialised local anaesthetic works by numbing the nerves that carry the pain impulses from the birth canal to the brain. Whilst it gives complete pain relief, it also means that you won’t be able to feel much if anything from the waist down, which can be a little unsettling.
The big advantages of an epidural are obvious – no pain! If the effects start to wear off, it can be topped up.
Sound too good to be true? Well, there are some negatives too. You may find that an epidural slows down your labour and your movement will be restricted depending on the local anaesthetic used and due to the additional monitoring required for both you and your baby. As it’s a delicate process, epidurals have to be administered by an anaesthetist, so are not available for home births or in birthing centres and even in hospital you may have to wait. The epidural isn’t instant, it can take 20 minutes to set up and a further 20 minutes to take effect. On top of that, if you are unable to feel your contractions, you may need help delivering the baby (ventouse or forceps).