Pain Relief in Labour

You may have noticed that I am not a woman. I’ve never given birth to a baby, and I will never know if childbirth actually hurts as much as a kick in the bollocks. Although I have an idea.

Yet despite all of this, I am aware of the taboo surrounding the choice of pain relief available to those ladies trying to squeeze something the size of a watermelon through something the size of a f*****g kiwi! Bravo ladies, bravo.

Pain relief/management was something that we discussed at one of our NCT classes the other week. I went into that class not really having a scooby do about what options an expectant mother has, other than an epidural. In fact, I’m sure there are many people reading this who know little more than I did. So I thought I would share some of my newly gained knowledge with you lovely people. Of course, there might be some mothers reading this who have already been through childbirth, if so, please let me know if the options available today as listed below are any different to when you gave birth.

Now, just because I’ve had one NCT class on Pain Management, does not make me an expert on the subject, and there are likely to be other options available and other views on what we discuss below, but I do now know the difference between an ibuprofen and an opiate. Although to be fair, I still have to spellcheck both of them.

Transcutaneous Electrical Nerve Stimulation [aka TENS Machine]

While these look like something that your grandma might have used back in the days of black and white TV’s and pressure cookers, these little battery powered gems are proven to help managing early labour pain.

You stick the wires/electrodes to your back using the provided pads, and the machine sends little electrical pulses through to your body which, in turn, interrupts the pain signals being received by your brain. Because of this, you’re brain gets all confused like WTF and starts switching off its pain receptors.

Be sure to start using it early on in labour on a low setting, and then notch it up as you go along. If you wait too long and only start using it further on into your labour, it is less likely to be affective.

You can get your hands on these machines quite easily. You can buy them online or rent them. Prices can vary but they all pretty much do the same thing.

So if you’re after a drug free early pain suppressant that does no harm to your baby, then a “Maternity” TENS machine might be the one for you. There are of course situations when people should not use one of these, and they are not suitable for everyone, so be sure to do your research and consult your midwife.

Gas & Air

Nitros Oxide, otherwise known as laughing gas, is mixed with oxygen and inhaled using a mask that goes over your nose and mouth, or via a tube that goes into your mouth. A bit like a regulator which deep sea divers use. The mother keeps hold of the mask/tube and chooses when to inhale and for how long, so they are in complete control. Within reason. They might have to wrestle it back from daddy every now and then if he want’s to give it a try. I know I do!

It doesn’t completely take away the pain, but most certainly helps as those contractions step up a gear and your anger towards your pain free baby making buddy beside you increases.

It takes a few seconds to kick in, so you want to breathe it in as soon as the contraction starts rather than waiting for the peak. It doesn’t stay in your system and wears off pretty quickly, having no affect on the baby.

Some brief side effects are feeling light headed while/after using it, some feel dizzy and others feel nauseous. However it is still the most regularly used form of pain relief during labour in the UK. It is available for planned home births, in midwife led units (MLU’s) and in labour wards.

Opiates

Pethadine is the most common opiate offered during labour. Others, although not as common, include diamorphine, meptid and remifentanyl.

Pethidine, diamorphine and meptid are pain relieving drugs given by injection into the thigh (or bum) and can take 15-30 minutes to take affect and usually last between 2-4 hours. They help you to feel a bit more relaxed and can help reduce anxiety, sometimes helping the mother to get some rest.

The downside to the likes of pethadine,  is that once it is in your system, it can last up to 4 hours. So if you don’t like the sensation, there’s not a lot you can do about it. They can also lead to breathing problems for the mother, and as these drugs pass through the umbilical chord to the baby, they can also have a similar influence on the baby with a chance that their breathing and ability to feed might be affected.

Epidural

Here it is. The one that everyone is most likely to think they know about. So let’s see how much you really know. An epidural is a pain relieving drug, administered by an injection into your spine. Right? Wrong! Boom! There you go! It’s not. Mind blown huh? That’s what I thought. Jen too! Ok, here are the facts.

Epidural analgesia during childbirth, is a regional anaesthetic that blocks the nerve impulses from the lower spinal segments which results in decreased sensation in the lower half of the body. It is only available in obstetrician-led units. That’s the hospital/labour ward to you and me.

You first have a small area of your back injected with a local anaesthetic in order to numb the area. A needle is then inserted between two vertebra in your back and a small tube threaded through, like a catheter. Once in place, the needle is removed and the medication provided via the tube through periodic injections, a bit like being on a drip. The tube is taped to your back, all the way up to your shoulder.

Generally, an epidural will provide almost total pain relief in about 90% of cases, with partial pain relief accounting for the other 10%. You are aware of the contractions and your brain is ticking over as normal, you just don’t feel the pain.

There are many things to consider if having an epidural. These include, but are not limited to;

  • Your blood pressure may drop, which is treated by giving intravenous fluids.
  • It takes about 20 minutes to insert and set up and another 20 minutes to work once injected, so plan ahead.
  • It may increase the need for forceps.
  • You will likely need a urinary catheter to empty your bladder.
  • You and your baby will have much more continuous monitoring.

So there you have it. There are other forms of pain relief too, such as water, meditation, hypnosis and acupuncture.

The important thing to remember is that the choice is yours. Nobody can tell you what to do, as much as no-one can accurately tell you how much it’s going to hurt. I mean, it’s going to hurt. We know that. Quite possibly even more so than a kick in the Mr Bojangles. But there is no accurate way of measuring pain, as every human being measures pain differently.

There are also no guarantees when it comes to pain relief. There will always be a small minority of cases where whichever method chosen does not work.

So go in there with a plan. Ask questions. Discuss the options with your partner and friends and family, but do not be led by anyone. You’ve been through enough already, yet there’s still so much more to come. So choose what you feel is right for you and forget everyone else. Whatever you decide, when you see your baby for the first time and you glance over at your partner who’s probably passed out on the floor, cradling his broken hand that you squeezed so tightly, it will all have been worth it.

T-minus 28 days!

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