Pain relief options at Dorset sites
|Bean bags/birthing balls/mats||Yes||Yes||Yes||Yes|
|Aromatherapy||Yes||Yes||Yes||Yes (if midwife is trained)|
|Gas and air||Yes||Yes||Yes||Yes|
Coping with labour
All labours are different – each woman deals with them in different ways, so try not to get too anxious about how your labour will be and how you will feel.
Some women shout or swear loudly, some remain calm and are quiet. Some prefer to hum songs or maybe tap tunes. It could be that you are tactile and want to hold your birth partner’s hand during the contractions, or you may want to have no physical contact. You might want to lie down or to keep moving. Some women like to sit on a bean bag or stand rocking their hips, or sit on all fours (which is great for the baby’s position). We are all different and there is no right or wrong way of coping with labour. Whatever feels natural to you is the best way.
There’s a lot that you and your birth partner can do to help during early labour, such as trying to relax at home and distracting yourself by keeping busy. Try to eat small amounts of food and keep drinking plenty of fluids.
The preparation for your labour starts antenatally, when you will be given lots of information about your options for coping with contractions. Being fully informed of all options will help you to decide what you would like to try. Your team midwife will be able to support and guide you to make your individual plan for labour, making it tailored to you as much as possible. Making your own decisions helps you to feel good about your labour and birth, and helps you to feel in control of the process.
Some women have clear plans of what they do and don’t want in labour. These can change as labour progresses. The midwife caring for you will support you and explain any changes that need to be made to your birth plan. Try not to feel bad if things change. Talk things through with the midwife or obstetrician caring for you, so that you understand why the changes are advised.
The Labour Line (0300 369 0388) is open 24 hours a day and they can give advice on coping with the pain of early labour. Taking paracetamol can be helpful in the early stages. Make sure you read the instructions on the packaging. Remaining at home as long as possible will help you relax, as you are in a familiar and more comfortable environment. Some women find listening to their favourite music or lighting candles can create a feeling of calm.
Your pain relief options
Concentrating on breathing slowly in and out will help you to remain relaxed. If you start to breathe too quickly, you will reduce your oxygen intake and become dizzy and feel panicked. Some women find it helpful to use relaxation CDs or techniques such as hypnobirthing (a method of pain relief that involves visualisation, relaxation and deep breathing). Hypnobirthing classes are offered privately in lots of areas, or there are DVDs and books available to purchase. If you plan to use hypnobirthing, it’s a good idea to start to practice the techniques as early as possible during pregnancy
Complementary therapies, such as massage and aromatherapy using essential oils, are natural non-medical ways to help with the contractions. Some midwives have had extra training for this.
Labouring in water can really help the pain. You can relax in a bath at home. Make sure the water covers your tummy! It can be useful to seal the overflow plug with blutack or similar but be careful the bath doesn’t overflow! Some women like to relax in the birthing pool in labour when in hospital. Some will choose to use it as pain relief only and some will choose to birth their baby in there too. Again, no decisions need to be made beforehand. Let the midwife who is going to care for you at home, or Midwife arranging your admission to hospital, know that you would like to use a birthing pool.
Some women choose TENS (Trans Electrical Nerve Stimulation) as a form of pain relief. This is a small machine that is attached to your lower back using four small sticky pads. It works by stimulating your endorphins, which are your natural painkillers, and reducing the pain signals sent to the brain. It can be used at home or in hospital. Many women report that it really helps them during the early part of their labour.
When natural methods of pain relief aren’t effective, there are other options. Pethidine, which is an opiate, is given by injection. This is usually given twice in labour and you must have at least 4 hours at least between doses. It will make you feel sleepy for a few hours. Some women will be nauseous or sick after receiving pethidine, but your midwife can give you an injection to help with this.
Gas and air, also known as laughing gas or entonox, is a combination of oxygen and nitrous oxide. Although it can make some women laugh, it can also have the opposite effect and make you cry, so don’t worry if this happens! You breathe it in through a mouthpiece and can regulate how much you have and when. This means that you can target your contractions for effective pain relief, but it wears off quickly, so you won’t feel constantly drowsy. It can make you feel dizzy or sick but doesn’t stay in your body for long, so any side-effects wear off quickly.
Epidurals are an effective form of pain relief. They work by blocking the nerve impulses from the lower spinal segments in your back. Epidurals are given by anaesthetists. Walking epidurals are not routinely offered in Dorset.
Remifentanil is a strong morphine-like painkiller that works quickly and wears off quickly. It is given through a pump called a PCA (Patient Controlled Analgesia) which allows you to control how much of the drug you receive, and when you receive it.
Remember, most women choose to have several of these forms of pain relief in labour, so don’t worry if you change your mind from your original birth plan. Discuss the plan with your birth partner antenatally – they can be your advocate and voice when in labour if you are finding it difficult to explain things.