It is difficult to know in advance what sort of pain relief will be best for you. The midwife who is with you in labour is the best person to give you advice. Many of the self help tips for managing pain at home can be used throughout labour. Below are some additional pain relief options which can be used.
Transcutaneous electrical nerve stimulation (TENS) is a gentle electrical current passed through four flat pads on your back. The TENS works by stimulating the body to increase production of its own natural painkillers called endorphins. They also interrupt the pain signal pathway sent through your spinal cord to your brain reducing the pain sensation. The TENS is most effective if used from early labour as it takes 30-40 mins to build up the endorphin levels and the electrical stimulation can be increased as the contractions become stronger. If you think you might like to try Tens, there are many outlets that they can be rented from e.g. Medicare Ireland, Boots outlets and selected chemists.
Entonox is a gas made up of 50% nitrous oxide and 50% oxygen. It is sometimes known as gas and air. It is available in each delivery room. You breathe Entonox through a mouthpiece that you hold yourself. To get the best effect, the timing is very important – remember to start breathing the gas and air the very second you feel a contraction beginning. If you wait until the contraction really hurts it will be working in between contractions which will be of little benefit. The midwife looking after you in labour will give you full instructions on how to use it.
It is simple to use, acts quickly, wears off in minutes and has no harmful effects on your baby. It will not take the pain away completely but it helps you to concentrate on your breathing which also helps in dealing with the contractions.
Pethidine is a morphine-based drug, which can help you to relax and cope with pain.
It is given by intramuscular injection usually in the leg or sometimes in the buttock. It takes about 20mins to work and the effects last 2-4 hours. It is usually given with another drug to stop feelings of sickness that may occur.
Pethidine crosses the placenta and can make the baby sleepy but it is considered to be safe and is the drug of choice. Pethidine will not take the pain of the contractions away completely but it can relax you enough to help you cope better with your contractions.
Epidural is an anaesthetic which is injected into your back. An epidural takes the pain away for most women. For an epidural, the anaesthetist gives you local anaesthetic and then puts a needle in the lower back and uses it to place an epidural catheter (a very thin tube) near the nerves in your spine. The epidural catheter is left in place when the needle is taken out so that the anaestetic can then be pumped in continuously or topped up when necessary. Your baby’s heart rate needs to be continuously monitored when you have an epidural. Your Doctor may decide that a spinal anesthetic or combined spinal/epidural anesthetic is more appropriate for you .if this happens it will be discussed with you at that time.
If you wish, you can request an epidural when you are diagnosed in labour. Sometimes administration of your epidural may be delayed if the anaesthetic doctor is attending to an emergency or another woman in labour. You will need to have a drip inserted into a vein in your arm to give you fluids and help maintain your blood pressure. It can take up to 40 minutes for an epidural to be effective (20 minutes to insert it and 20 minutes to take full effect). You may not get out of bed for the duration of your labour and for several hours afterwards. You will need to have a small tube called a catheter inserted every 2 hours to help empty your bladder. The midwife may need to tell you when to push.
The Obstetric Anaesthetists' Association in the U.K. has produced comprehensive patient information leaflets outlining the various options for pain relief during labour. All options may not be available at every hospital. The leaflet can be accesed via this link: Obstetric Anaesthetists' Association leaflet