Pain in birth is a common fear for women, but this doesn’t need to be the case! When you are in labour your body releases a cocktail of hormones (mainly endorphins and oxytocin) which provide natural pain relief. There is also a vast range of pain relief options that you can use in labour if you choose so. Don’t be afraid of the pain – if you reach a point in labour where you want to use pain relief you absolutely can! We have some really great options available, which I have outlined below…
Breathing – Breathing is so important during labour. Slow, regulated breathing can trigger the parasympathetic nervous system which helps you to relax. When we are uncomfortable or in pain we often hold our breath, so focussing on slow, deep breaths can be really beneficial.
Movement – freedom of movement during labour is very important. Rocking from side to side, forward leaning positions, hands and knees are all great for creating space in the pelvis and using gravity to help baby to move down. Many women are most comfortable and better able to handle labour when they are not lying flat on their back on the bed.
Water – both the shower or bath can help you to manage the intensity of your labour. Many women find the sensation of water running over their back or belly helpful. Floating in a warm bath allows you to feel weightless and to move more freely, which can assist in your ability to manage your contractions. The warmth of the water also helps you to relax.
Heat – a heat pack on lower back or tummy can help release muscle tension, especially in early labour.
TENS machines – TENS stands for Trans-Electrical Nerve Stimulation. A TENS machine is a small battery operated device with four sticky electrode pads that are placed on the lower back. TENS machines are to work in labour by interrupting the pain pathways to the brain and helping your body to release endorphins (our natural pain relief).
Massage – firm massage around the lower back and hips can help to reduce discomfort in these areas. The hip squeeze and counter pressure are two great techniques to try (ask your midwife about these!).
Hypnobirthing – Hypnobirthing involves the use of self-hypnosis to help you relax during your labour and birth and to reduce fears in the lead up to birth. There are many different hypnobirthing programs, with some such as the Hypnobirthing Australia program including many other techniques to help you manage the intensity of your contractions, as well as important information to help you to make informed decisions along your journey.
Gas and Air – The ‘gas’ offered to women in labour is a combination of nitrous oxide gas and oxygen – similar to happy or laughing gas. It is only used during contractions and you breathe through a mouthpiece to deliver the medication. You can still move or labour in the bath/shower if you choose. Some women do feel a little light headed or nauseous but this usually resolves by stopping use of the gas for a period of time.
Opioid medications – Opioid medications such as morphine, pethidine and fentanyl are given via an injection and can provide strong pain relief. The effect can last up to a few hours depending on the medication used use. Hospitals vary widely with what opioid medications they use so I recommend having a chat with your provider about this.
Epidural - An epidural involves an anaesthetic medication injected into the back which results in an altered or numb sensation from the waist down. A needle is used when inserting the epidural, but only a very thin plastic tube is left in the back so your midwife can give you doses of the medication to keep the epidural working, or you may have a button you can press to top up the medication. Unfortunately you usually cannot walk around, will require an intravenous drip, catheter into your bladder and continuous monitoring of your babies heart rate with an epidural. Epidurals are generally very effective, and can allow you to sleep if you are exhausted from a long labour.
It is important to research the different pain relief options available so that you know what you would like to try on the day. During your labour you may try a few different options. Sometimes it takes a few contractions to really see if a technique or medication is working so give it a bit of time before moving to the next option. Many pharmacological pain relief medications do have side effects so it is important to be aware of this when making your decision. Not all women choose to have pain relief either – often women are pleasantly surprised at how effective their natural pain relieving hormones are! Either way, the decision is completely yours.
Article written by PBC Expo Midwife Hannah