Pain relief in labour
Labour and birth
Pain relief means stopping or reducing the pain you feel during labour with medicines or medical treatments. Pain relief can include:
- gas and air (entonox)
- diamorphine injection
- spinal anaesthetic
- patient-controlled analgesia (PCA) pump
Each method has advantages and disadvantages. We have included these to help you decide which method is best for you.
If you have any questions or concerns, please speak to your midwife.
This is a mixture of nitrous oxide and oxygen, also known as gas and air. It is simple, quick to act and wears off in minutes.
You breathe the gas through a mouthpiece. To get the full benefit you should start breathing it as soon as the contraction starts, and stop as soon as it ends.
|Disadvantages and risks|
This is an opioid (morphine based painkiller) injection. It helps with pain by acting on your body's central nervous system.
It will only be used if it is appropriate to your situation during labour.
It might be offered to you for your labour if you would like to stay at the Home from Home birth centre but would like some stronger pain relief. You might also have it if you cannot have an epidural.
Your midwife can give you the injection while you are in hospital. It cannot be used at home.
It can be given at any time during your labour but is best to be given before you start pushing.
This is a local anaesthetic in your back that should stop you from feeling pain. It's the most complex form of pain relief and must be done by an anaesthetist.
If you have certain bleeding disorders and complications during pregnancy it might not be suitable for you.
You have a drip, giving you fluid into a vein in your arm. We'll ask you to curl up on your side or sit bending forwards. We'll clean your back and give you a small injection of local anaesthetic into your skin. This will help with any discomfort when the epidural is put in.
A small tube is put into your back, near the nerves carrying pain from the womb. This needs to be done carefully, as puncturing the bag of fluid surrounding the nerves might give you a headache afterwards. It's important to keep still while the anaesthetist is putting in the epidural. After the tube is in place you will be able to move.
Once the tube has been put in, pain medicines can be ‘topped up’ as often as you need them, by a pump that you can control.
Your midwife will check your blood pressure regularly, as the pain medicine might cause your blood pressure to fall slightly. The anaesthetist and your midwife will also check that the epidural is working properly by using a cold spray on your abdomen and legs to test your sensation. They will ask you about your pain to check how the epidural is helping.
It usually takes about 20 minutes for the epidural to work. Sometimes it does not work well at first, and some changes might be needed.
Your baby might be continuously monitored using a fetal heart rate monitor, also known as a cardiotocograph (CTG) once the epidural is put in. This can be stopped after 30 minutes if it is safe to do so.
Epidural for assisted birth or caesarean section
If you need an assisted birth procedure (such as a forceps, or a caesarean section), your epidural can usually be made more effective to allow this to take place without any pain.
A stronger local anaesthetic and other pain medicines are injected into your epidural tube. This is safer for you and your baby than having a general anaesthetic.
If you have not had an epidural, a spinal anaesthetic can be used.
Epidurals are slow to act, particularly in late labour. If the pain medicines are put directly into the bag of fluid around the nerves in your back, they work much faster. This is called a spinal anaesthetic.
Some people cannot have an epidural or spinal anaesthetic because they have certain health conditions. If this is the case, the anaesthetist will speak to you about other types of pain relief.
Opioids (morphine type painkiller) can be given through a small tube put in one of your veins. The opioids are put into a pump and you are given a button to press so that you can give yourself pain relief when you need to.
The equipment is set up so that you cannot overdose (have too much pain medicine).
Resource number: 0075/VER4
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