PAIN RELIEF IN LABOUR

The amount of pain experienced by women during childbirth varies. For some women, the pain is intense and agonising; for other women there is little to no pain.

Many factors affect pain perception; fear, number of previous births, foetal presentation, cultural ideas of childbirth, birthing position, support given during labor, beta-endorphin levels, and a woman's natural pain threshold. Uterine contractions are always intense during childbirth. Some women report these sensations as painful, though the degree of pain varies from individual to individual.

Non-medical pain control

Some women believe that reliance on analgesic medication is unnatural, or believe that it may harm the child. They still can alleviate labour pain using psychological preparation, education, massage, hypnosis, water therapy in a tub or shower. Some women like to have someone to support them during labour and birth; others deliver in a squatting or crawling position in order to more effectively push during the second stage and so that gravity can aid the descent of the baby through the birth canal.

The human body also has its own method of pain control for labour and childbirth in the form of beta-endorphins. As a naturally occurring opiate, beta-endorphin has properties similar to pethidine, morphine, and heroin, and has been shown to work on the same receptors of the brain. Like oxytocin, beta-endorphin is secreted from the pituitary gland, and high levels are present during sex, pregnancy, birth, and breastfeeding. This hormone can induce feelings of pleasure and euphoria during childbirth.

Water births are being increasingly chosen by many women as an option for pain relief during labour and childbirth. Many hospitals and birthing centres now offer women the option of having a waterbirth, either via custom-made 'birthing pools' or large bath tubs.

Self-hypnosis, acupuncture and TENS (transcutaneous electrical nerve stimulation) are other non-pharmaceutical methods that may help to relieve pain.

Medical pain control

Inhaled nitrous oxide gas can be given to ease pain and is often used in the early stages of labour. It can cause lightheadedness and nausea, and should not be used throughout labour.

Pethidine (an opiate drug) is a painkiller that is often prescribed by midwives if nitrous oxide gas does not relieve pain. However, pethidine is a poor analgesic and can cause nausea and vomiting. In addition, the drug can cross the placenta to reach the foetus creating the risk of respiratory depression in the newborn. It is not a good drug to use in labour.

Epidural analgesia, where an injection is given into the back (to block the nerves), is a safe and extremely effective way to relieve pain. Since the drugs used do not enter the mother's circulatory system, none of the drug will enter the bloodstream of the foetus. The epidural procedure is carried out by a doctor (an anaesthetist) and is considered the "gold standard" for analgesia in labour.

Spinal anaethesia can be used if a caesarian section is necessary.

More information about pain relief in labour is available below; it covers the following areas:

• What pain relief options are available?
• Alternative pain relief methods
• What happens during labour?
• Why is labour painful?
• Should I have pain relief?
• Breathing exercises
• Tips and advice
• Epidural as pain relief
• Ambulatory Walking Epidural
• Entonox
• Meptid (Meptazinol)
• Tens
• Pethidine
• Spinal Pain Relief