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Labour and birth - pain relief

The experience of pain in labour is different for everyone. Some women prefer to avoid using drugs for pain relief in labour. This is a personal choice and we will support you in your decision. Labour and birth is usually a painful experience for most women. It is a good idea to be aware of the options for pain relief and to know how you would receive pain relief drugs if you feel you need them. We encourage the use of ‘non-drug’ options including the use of water (shower/bath), positioning, massage and breathing awareness. Your support person also plays a very important role during your labour.

Non-drug options

Generally these methods aim to stimulate the release of your body's own 'pain killers' - endorphins, and increase the release of oxytocin - an important labour hormone.

  • Breathing and relaxation - Relaxation helps to reduce the tension in muscles, thus decreasing pain level. It involves techniques such as breathing patterns where you keep your breathing rhythmical and try to relax every time you breathe out (exhale). It may be helpful to think of the word RELAX, breathing in for R-E and out more slowly for L-A-X, so you are focussing on the exhalation breath. Relaxation breaks the ‘tension-pain-anxiety’ cycle and helps you cope with labour pain. Using distraction techniques, such as concentrating on music or visualisation helps to block the pain as well. Practising these techniques in pregnancy will help you use them during your labour.
  • Mobility and Position - Some positions are more comfortable in labour and active, upright positions encourage your baby to move through the pelvis. Being active may also reduce the length of your labour. Rocking your pelvis from side to side, or round and round, helps your body to work with contractions. The rhythmic movement will ease contraction pain, and help your baby move down the pelvis.
  • Massage - Massage can help to block the transmission of pain impulses to the brain and techniques include rhythmic stroking, touch relaxation, or deep counter-pressure. As your labour becomes more intense, you can let your support person know where the massage feels best.
  • Heat - Heat can be very effective in relieving tension and increasing relaxation. A warm bath, shower or heatpacks on your back or lower abdomen may be helpful. Warm, moist packs on your perineum (the area behind the vagina) can help with stretching pain during second stage and help to reduce tearing.
  • Transcutaneous Electrical Nerve Stimulation (TENS) - This is a small, battery-operated unit that puts out a series of mild electrical impulses. The strength of these can be adjusted and will feel like a tingling sensation on your skin. TENS help to block pain messages to the brain and also stimulate endorphins, your body’s natural painkillers. If you are considering using TENS, it is advisable to have some prior instruction on its use during your pregnancy. Contact the physiotherapy department on 5320 4465.
  • Sterile water injections - This is a non-drug option of tiny amounts of sterile water given by small injection under the skin on your lower back. It may be very effective in relieving backpain in labour, and lasts 1-3 hours.  

Drug options

Medications used for pain in labour may affect you and your baby in different ways. The following options are offered at BHS, and more detail on the effect of labour medications is provided on the external links section, under labour and birth.

  • Nitrous Oxide - ‘Gas’ is self-administered by mouthpiece, takes 20-30 seconds to take effect and works for as long as it is inhaled. It is easy to use but needs to be timed carefully for maximum benefit. You may experience drowsiness, some confusion, nausea or vomiting.
  • Pethidine - This is given by injection into your leg, and takes 15-20 minutes to start working. It usually lasts from 2-3 hours. It will help to ease the pain and increase relaxation.
  • Remifentanyl - ‘Remi’ is a fast acting morphine-like drug which is delivered through an intravenous ‘drip’ when you push a small button (patient-controlled or PCA). It may make you sleepy but the effect wears off quickly and you are monitored closely during use.
  • Epidural Block - This is given in the form of an injection into the spine through a fine plastic tube and is an effective form of pain relief.  The drugs can be pumped slowly and continuously or self-delivered in very small doses according to your needs. Your labour becomes more ‘technical’, requiring a drip, urinary catheter and continuous monitoring of both you and your baby. Please see this informative video for further information about Epidurals.  http://www.agb.com.au/obstetrics-information-presentation.html

More information on pain relief in labour