Pain Relief During Labour

Category: Birth & Beyond

Various pain relief options are now available to help you ease those labour pains. Be sure you know which ones you think are best for you and your baby.

WORDS NURULHUDA SUHAIMI

 

The best things do not come easy, right? And expecting a baby is definitely on top of the list of the best things that can happen to any mother. Unfortunately, you will most likely go through a lot of pain during your labour before you get to see your little bundle of joy. You probably have heard stories from other mothers of their labour and delivery experiences, or you may have done your own research on what to expect when your time comes. Pain during labour is inevitable, so we have broken down for you the different kinds of pain relief options to help make your labour experience a bit more pleasant.

 

Epidurals

This is probably one of the most common types of pain relief that women opt for to ease their labour pains. This procedure involves the anaesthetist firstly inserting a needle into your lower back. The anaesthetist will then pass a very thin tube through this needle near the nerves that are responsible for carrying pain impulses from the uterus. If the tube is placed successfully, the needle will be removed and a local anaesthetic will subsequently be administered into the tube.

 

Setting up the epidural will usually take about 15 minutes, while the drugs will require another 10 to 15 minutes to take effect. Once everything is ready, the local anaesthetic will continually and gradually be injected through the tube to ensure that the pain relief remains constant throughout labour until delivery.

                 

Epidurals are especially helpful for women who are experiencing a long and difficult labour such as in first-time mothers. But be sure to keep in mind that epidurals can only be administered by an anaesthetist, so if you are planning on having a home birth, epidurals are not an option.

 

 

While epidurals are considered to be very safe, some temporary side effects

may still arise as a result of the local anaesthetic.

 

 

According to obstetrician and gynaecologist, Dr Ong Xiaohui from Hsuan & Xiaohui OG Clinic, Thomson Medical Centre, women may experience low blood pressure, loss of bladder control and itchy skin, but there are ways to help with these side effects. “The patient’s blood pressure will be closely monitored during labour, and usually a urine catheter is inserted into the bladder to drain her urine,” explains Dr Ong.

                 

Other side effects, although rare, include backaches, severe headaches, infection and epidural haematoma.

 

Pethidine

Unlike epidurals, pethidine is injected into the muscles (typically thigh) by a nurse or midwife to relief labour pain. The drug may take about 20 minutes to work after it has been injected.

                 

This method of pain relief is not as effective as epidurals as it only offers a short relief from labour pain. The effectiveness of pethidine differs among patients.

                 

Side effects include drowsiness, nausea and vomiting. To counter nausea and vomiting, an antiemetic will be given to you. Most important thing to be aware of, pethidine crosses the placenta to the baby, which may result in the baby getting drowsy especially if it was injected within two hours of birth. Therefore, this drug will usually not be administered in the late stages of labour.

 

Entonox Gas

A mixture of oxygen and nitrous oxide, the effectiveness of entonox gas in relieving labour pains may not be very successful for some mothers. This method requires you to breathe in gas, which is being drawn from a machine beside the bed, through a mask or mouthpiece. The gas takes about 15 to 20 seconds to be effective, thus you have to inhale – slowly and deeply is best – before each contraction so that the gas can do its job of relieving those pains.

                 

Opting for entonox gas is a safer alternative to being administered with drugs as the gas does not stay and build up in you or your baby’s bodies. You may still experience some side effects such as light-headedness and drowsiness. If this occurs, you can choose to stop this procedure and opt for an injection of a pain-relieving drug like pethidine instead.

 

TENS Machines

Transcutaneous electrical nerve stimulation, or TENS machines, are recommended to be used right from the early stages of labour. They work at reducing labour pains by releasing small pulses of electrical energy into the skin via pads. “Electrodes are taped onto your back and connected by wires to a small battery-powered stimulator. Holding this, you give yourself small, safe amounts of current through the electrodes,” says Dr Bernard Lee Mun Kam, senior consultant interventional pain specialist at Paincare Center @ Alvernia, Mount Alvernia Medical Centre. “TENS is believed to work by stimulating the body to produce more of its own natural painkillers called endorphins. It has also been suggested to reduce the number of pain signals that are sent to the brain by the spinal cord.”

                 

 

TENS machines are not known to result in any side effects for either you or your baby,

and are generally safe to be used by most patients.

 

 

However, certain groups of people, as identified by Dr Lee, should consult their doctors first before using the machine if:

❖               They have a pacemaker or other types of electrical or metal implants in their body.

❖               There is a possibility that they might be pregnant, or are in the early stages of pregnancy.

❖               They have epilepsy or a heart rhythm disorder (arrhythmia).

 

If you notice your skin becoming red and irritated after using the TENS machine, it may be due to an allergy you have to the pads. If this happens, don’t worry because there are pads specifically made for those who are allergic to the regular ones.

                 

If you are choosing the TENS machine route, be sure to check with your hospital first if the machines are available there. If not, you can buy or hire one.

 

Birthing Pool

For women who prefer a more natural alternative to pain relief, they may consider using a birthing pool during their labour. The warm water can help you relax, especially if you are experiencing strong and frequent contractions that can worsen if you become tense. Consequently, the water’s relaxing effect can allow you to focus on breathing calmly, rather than taking short and shallow breaths that can exacerbate the contraction pains.

                 

It is important to ensure that the water temperature is at an optimal temperature for you and your baby. “Keep the temperature of the water at or below 37ºC at all times (35ºC to 37ºC is optimum during the first stage of labour and 37ºC to 37.5ºC during the second). If you become overheated it can cause distress to the baby and discomfort to you,” advises Dr Lee.

                 

If you find that the water is not helping with your labour pains, you can still request for a pain-relieving drug such as epidural or pethidine, but you will be required to leave the pool. You may also be asked to leave the pool if there is a problem with your baby’s heartbeat, you experience vaginal bleeding during labour, an increase in your blood pressure, and if your baby’s first poo (meconium) stains the water.

                 

Water births can be done at home or in the hospital. If you opt for a hospital delivery, check with the hospital first in case they have any restrictions imposed on how you can use the pool.

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