Labour can be a daunting time and you may have a lot of unanswered questions. There are many options for pain relief during labour and where you plan to give birth will affect way access you have to it. We are unable to offer an epidural in the birth centres and if you're at home you will only have access to Entonox.
Being able to relax rather than tense up during a contraction helps your body manage labour better. Many antenatal classes cover relaxation and breathing techniques and it's good to find out about these.
Whether or not you think you'd like to have pain relief in labour, it's a good idea to find out about what the different types are and how they work. Click on the sections below to read more about the different types of pain relief and remember to also talk to your midwife.
You may wish to consider using natural or non-medical methods to cope with the pain of labour, including:
- Adopting upright positions and remaining mobile: "See Positions for labour and birth"
- Relaxation and breathing techniques
- Self-hypnosis (such as hypnobirthing or natal hypnotherapy)
- Support from someone you know and trust
Trans Electrical Nerve Stimulation (TENS)
A TENS machine sends a gentle electrical current through four flat pads stuck to your back. This creates a tingling feeling. You remain in control the strength of the current yourself. It is not known exactly how a TENS machine helps to relieve pain, but it is thought to 'distract' the nerves that transmit pain. It may also help to increase the levels of your body's own natural pain killers, which are called endorphins.
It is sometimes helpful at the beginning of labour, particularly for backache. If you hire a TENS machine, you can start to use it at home. It needs to be put on early in labour and you'll probably need a birth partner to help with this.
We do not provide TENS machines, so before labour you will need to hire or purchase one for use when you come in to have your baby.
TENS machines have no known harmful effects on your baby. TENS cannot be used in the birth pool.
Using Water During Labour
Water can be used to help you stay mobile and provide pain relief throughout labour. Some women find that water helps them cope better with pain. The water provides support for your body so you can move freely and the warmth can help you feel relaxed.
You can hire a birth pool to use at home or there may be one available at your hospital or birth centre. A birth pool is larger and deeper than a bath so there is space to move in the water.
Tell your midwife as early in your pregnancy as possible if you'd like a water birth, as special arrangements may need to be made. If you're planning a home birth, your midwife may be able to recommend places to hire a pool. We are keen to support you to have a normal labour and birth.
Gas and Air (Entonox)
Entonox is a mixture of two gases, oxygen and nitrous oxide, which is inhaled using a mouthpiece. This is a common form of pain relief that can be used at any stage of labour and along with other forms of pain relief.
It is available in all our birthing rooms, and if you are planning a home birth, entonox will taken to your home when you are in labour. Many women find it a helpful method of coping with pain, although some do not find it effective enough and go on to use other methods.
If you use gas and air, you can be in control of how you use it. It's fast-acting - within about half a minute - and the effects stop quickly if you stop taking it, so it's best used for the duration of a contraction and not in between contractions.
If you inhale too much, however, you may become disoriented and confused, and it makes some women feel a bit sick.
Opiate medications can be used during labour, common variations can include pethidine or diamorphine. This is usually given by injection.
Diamorphine is an opioid drug. It is usually given by a midwife injecting it into a large muscle in your leg.
This type of pain relief is often limited. You will start to feel the effects after about half an hour and it usually lasts a few hours.
Some women say that using an opiod drug makes them feel more relaxed and less worried about the pain. Other women are disappointed with the effect of opioids on their pain and say they feel less in control.
As some women experience nausea and vomiting, your midwife may suggest an anti-sickness injection.
Diamorphine can make you drowsy and it may cause your baby to be slow to breathe after birth, if they are given Diamorphine too close to his or her birth. If this happens your baby will need immediate help to start breathing with stimulation and air.
Having Diamorphine prevents you using the birthing pool for 2-4 hours after you've had the injection.
An epidural is a local anaesthetic which is injected into part of your spine and is used for pain relief during labour. It works by numbing the nerves carrying pain messages from the lower part of the body to the brain.
There are a few steps to being given an epidural:
A drip in your arm will be needed to help keep your blood pressure stable
- An anaesthetist rather than a midwife will then ask you to sit or lie on your left side so that they can insert a needle into a gap in the bones of your spine
- A thin plastic tube called a catheter is then fed through the hollow needle. The catheter is taped to your back and the local anaesthetic can be injected through it and topped up throughout labour without causing any pain.
The epidural can be more difficult to site and may take longer to place if your BMI is raised, so it may be better to insert it early in the labour. It would then be in place if you were to require a caesarean birth or delivery of your baby more quickly by forceps or ventouse.
Epidural - pain relief in labour
The Active Birth Centre
The Active Birth Centre aims to support and inform women about natural labour and birth. It also provides Active Birth yoga classes, and the website includes information about trained active birth yoga teachers around the UK. There is also a section on water birth and birthing pool hire.