Pain relief

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TENS Machine
Gas
Narcotics injection
Epidural
Spinal injection
Natural pain relief

Pain relief

Each woman’s pregnancy and labour experience is unique.

It’s important to prepare yourself and create a birth plan. This includes considering your options for pain relief. Even if you intend on having a natural birth without pain relief, you should understand your options.

This guide will give you an overview of the options available to you. You will have the opportunity to discuss pain relief options at your birthing classes and during your pre-admission appointment.

You should review them with your birthing partner and discuss your preferences with your obstetrician.


TENS Machine

Transcutaneous electrical nerve stimulation, also known as TENS, is a form of pain relief that some women find helpful during labour.

Electrode pads are placed on your back and connected to a battery-powered machine that sends small pulses of electric currents through your body. These currents generally create a tingling sensation on your skin and are thought to help alleviate pain during contractions by stimulating your nerves.

Pros:

  • Can be used during any stage of labour
  • No side effects for your baby
  • Easy to move around and change positions while using.

Cons:

  • Some find it uncomfortable
  • Will not completely eliminate your pain
  • Can’t be used in the shower or bath


Gas

Nitrous oxide mixed with oxygen is another form of pain relief that you can try during your labour. When you breathe in through the mouthpiece, a measured amount of the gas is delivered. The strength of the gas is adjusted as your needs change.

Generally you will only use the gas during contractions. It works best by breathing in as each contraction starts. Once the contraction finishes, you will continue breathing as normal.

Pros:

  • Can be used during any stage of labour
  • No side effects for your baby
  • Easy to move around during your labour while using the gas

Cons:

  • May not completely relieve your pain
  • Not effective for all women


Narcotics injection

You may receive a one-off intramuscular injection of a narcotic. This injection will block pain receptors and relax your muscles, which will help you cope with the contractions.

Narcotic injections are generally given in the first stage of labour, and are not recommended close to delivery. They usually take around 20 minutes to take effect and can last between two to four hours.

Pros:

  • Can be administered by a midwife

Cons:

  • Can make you feel drowsy and nauseated
  • Can affect your baby if given too close to delivery.


Epidural

An epidural is used for both vaginal and caesarean deliveries. It’s an injection of a local anesthetic through a catheter in your lower back performed by an anaesthetist.

For the procedure, you will be asked to sit up and lean over a pillow, or lay on your side curled into a ball. The anaesthetist will prepare the area with a antiseptic solution, and a small dose of anesthetic will be injected into your skin. The anaesthetist will then insert a needle into the space between the vertebrae in your spine.

A small, soft plastic catheter will be inserted, which will deliver the anesthetic to epidural space. This will interrupt signals from your spinal nerves The catheter will remain inserted throughout your labour and delivery and give continuous pain relief.

Pain relief usually comes pretty quickly, but it can take up to 30 minutes for the pain to disappear. An epidural can be given during any stage of labour, but it’s usually performed in the first stage.

Pros:

  • Effective and complete pain relief for most women
  • You should be able to move and push during your labour
  • Allows you to remain awake during a c-section

Cons:

  • May prolong the second stage of labour
  • Your baby will need continuous monitoring
  • Your blood pressure will be monitored closely
  • Increases risk of instrumental birth and use of oxytocin.

Recovery

It usually takes one to two hours for an epidural to wear off completely. Generally, epidurals are very safe, but occasionally complications can occur. In the weeks following your delivery, you should contact your doctor immediately if you experience:

  • increasing weakness in your legs
  • unsteadiness on your feet (tripping or stumbling)
  • changing sensations such as numbness or tingling
  • pain, redness or discharge at the injection site
  • increasing back pain.


Spinal injection

This is another injection that is given by an anaesthetist. It’s suitable for both vaginal and caesarean deliveries.

Similar to an epidural, the spinal injection is administered to the lower back. Unlike an epidural, it’s a one-off injection, and the needle will go deeper into the space between your vertebrae. The anesthetic is delivered directly into the spinal fluid and nerves, which means it will act faster than an epidural. Depending on the type of medication, you may feel completely numb from the waste down for several hours.

Spinal injections can be used during the later stages of labour, or when your labour is progressing very quickly and you can’t wait for an epidural. The effects generally wear off after a couple of hours.

Pros:

  • Pain relief is immediate
  • Little to no side effects for your baby.

Cons:

  • You will not be able to move once you’ve been given the injection
  • The numbness may make it difficult to push during delivery
  • Your baby will need to be monitored closely.


Natural pain relief

There are a range of natural pain relief options available to you to help you manage your contractions during labour. This includes:

  • Showers
  • Water immersion
  • Dancing or movement
  • Hypnobirthing or calm birth techniques
  • Massage
  • Heat

For more information, speak to your midwife.