HOT TOPIC- Pain relief in labour.
One of the most highly sought-after advice for women attending antenatal classes is information about pain relief options for labour.
Way back in the day, there used to be the chloroform option, or the chloroform option- in other words, no real options at all.
Today there are a wide range of options which can be used by themselves, or in combination with a variety of other choices. So, in no particular order, here are some suggestions.
T.E.N.S. stands for Trans-cutaneous Electrical Nerve Stimulation and a TENS machine is a device that delivers small pulses of electrical current that assist in reducing pain during labour. The TENS machine is attached to small sticky dots, which are placed onto your back and a very small electrical current runs through wires which connect the dots to the machine. T.E.N.S. has no known side effects and T.E.N.S. machine are available to hire or buy- often from a physio or a chemist.
Massage is great for pain relief and no special training is required for your support person to provide you with massage during labour. Massage can be done with any type of oil (provided you have no allergies) and the oils can also incorporate essential oils if you wish. One of the benefits about massage is that it can be adjusted instantly to suit the laboring woman- the depth can be changed, the area being massaged can be altered and it can be stopped immediately if the woman wishes.
Hot packs come in all shapes and sizes and can be used in multiples. Back pain? Hot pack on the back. Abdomen pain? Hot pack on the abdomen. Painful mother-in-law in the birthing room? Throw the hot pack at her. So many uses!
Visualization is forming a mental image in your mind. Picturing a calm beach for example or, in labour, picturing contractions as waves coming and going. Visualization assists in a number of ways in labour, including decreasing fear, distracting the laboring woman from the discomfort and assisting with relaxation.
Calm Birth is an Australian childbirth education program which recognizes the correlation between the mind and body during childbirth and provides you with the factual information and tools you need to make the most of this connection during labour. Calm Birth educators are specially trained to provide you with information and provide you with the means to navigate labour and birth, however that occurs.
A Rebozo is a long-woven scarf, traditionally used in Mexico to support women in labour. It can be used to support the woman’s abdomen, relieving some of the weight of carrying a baby, it can be used for gentle pressure to assist in pain relief and is gaining popularity with people all over the world.
Water immersion is great for pain relief in labour. The warmth, the weightlessness the cocooning feeling. It can ease muscle tension and assist in relaxation during labour. Climbing into a bath or spa has assisted many women during labour and is suitable in most circumstances. If you are giving birth in a hospital, some hospitals may have a policy that dictates the laboring woman get out of the bath when the baby is close to arriving. This is something you should discuss with your midwife at the place you will be giving birth. The subversive in me laughs at the thought of hospital staff trying to get a laboring woman out of a bath if she is determined to stay in there. Birth centers will generally have facilities for women to give birth in water and are more likely to be supportive of this option.
Showers are similar to a bath, but some women find it more comfortable to remain upright in a shower while in labour. Being upright helps gravity do some of the work of encouraging your baby towards the appropriate exit.
Movement during labour provides distraction from discomfort, a sense of greater personal freedom, and a chance to release the muscle tension that can make labour more painful. Movement enables the body to find the most comfortable position at the time and many women find this very helpful for pain relief.
Plants have long been proven to promote health and pain relief. Many medications we use today are based on plant derivatives, so it is not surprising that oils from plants can assist in pain relief during labour. Aromatherapy for pain relief can be used in conjunction with massage in massage oils or in an aromatherapy burner (electrical if you are in hospital- no naked flames near the happy gas please). If you are planning on using aromatherapy for labour, you need to consult an appropriate professional about types of oil to use. Some oils can have unwanted effects, for example Clary sage, have been known to increase blood pressure, and should be avoided while pregnant.
Recent studies have found that a combination of reflexology and visualization can have an effect on decreasing pain in labour. There are pregnancy specific classes which teach reflexology for labour and birth, for example the She Births program, which can be undertaken in person or online.
Sterile water injections
These are injections of sterile water just under the skin in the lower back area and are particularly useful for women with a lot of back pain during labour. Usually injections are given in four different places in your lower back, just beneath the skin.Your midwife will be able to administer these and there are no known side effects for this helpful pain relief option.
Nitrous oxide (happy gas) Happy gas is nitrous oxide mixed with oxygen. It is also called Entonox, laughing gas or just gas. Gas can help with pain relief, and it is safe for you and your baby. You breathe it in through a mouthpiece or mask and wears off quickly if you do not find it useful or if you do not like the “floaty” sensation that some women experience. Happy gas can sometimes make women feel nauseous but this quickly wears off and there are no known side effects to the babies of women using gas as pain relief.
Narcotics (pethidine or morphine)
Narcotics are strong pain-relieving injections which can take 20 to 30 minutes to start working and about 4 hours to wear off. As with all pain relief options, some women find this option very helpful and some find the effects uncomfortable. Narcotics take away some of the pain and a lot of women report still feeling the pain, but not caring about it as much. Narcotics also travel through the placenta to your baby. Because of this, an internal examination will often be suggested prior to the administration of narcotics, to ensure your baby isn’t going to arrive in the next few hours. As narcotics can depress the breathing function in babies,they may need assistance to breathe after narcotics have been administered to mum too close to birth.
An epidural is a local anesthetic which is injected into your spinal cord. This stops the pain but also means that you will have altered feeling from about the waist down and won’t be able to walk during labour. You will also need an intravenous drip (an IV) when you have an epidural. This is because an epidural can cause a sudden drop in blood pressure and you may need a rapid infusion of fluid to reverse this issue. You will also probably need a catheter, which is a tube into your bladder, because the lack of sensation below the waist also means you cant feel the sensation necessary to go to the toilet.
Pain relief in labour is a very individual choice and what suits you wont suit others. There is no right and no wrong when it comes to pain relief in labour. Nobody gets a medal and everyone gets a baby, so it is up to you to make the choice based on your individual preferences.