Page last updated at 11:03 GMT, Thursday, 18 May 2000 12:03 UK

Pain relief during labour

Injection
Drugs can ease the pain of labour
One of a pregnant woman's greatest concerns is the pain of labour and how to lessen it.

A variety of methods exist. Some women can get by with natural pain relief, such as TENS machines and relaxation techniques while, for others, these seem to have little effect.

Much emphasis has been placed in recent years on natural childbirth and many women are concerned about the effect of strong drugs on themselves and the baby.

Health experts advise women to look carefully at all the options, decide which they would prefer, but keep an open mind as they may change their mind once labour has begun.

Signs of labour include the release of a sticky pink mucus plug from the vagina, regular contractions, backache and the release of the sac of water in which the baby has been floating.

Natural techniques:

These include massage, music, controlled breathing, acupuncture, keeping mobile, bathing and adopting comfortable positions for childbirth.

Massage can help in the early stages when contractions are beginning, but some women do not like to be touched during labour.

Many women say a warm bath can relieve the early pains.

It is also important for the woman to get into positions which are comfortable.

Many women, for example, find that squatting is the easiest position for giving birth.

Others may prefer to lean against a wall or sit with their stomach facing the back of a chair.

TENS machine:

The TENS machine - transcutaneous electrical nerve stimulation - works by stimulating the production of the body's own painkillers - endorphins - through electrodes fitted to the woman's back.

The woman controls the strength of the electric current through a hand-held device, ensuring that it is safe.

No known side effects to women or their babies have been reported as a result of the use of TENS machines.

They can be issued in hospital or can be hired out before the expected delivery date for use at home in the early stages of labour.

Gas and air (Entonox):

Once in hospital, women may be given a mixture of oxygen and nitrous oxide through a mask or mouthpiece, allowing them to control the amount they take in.

Entonox does not relieve all the pain of labour, but it can take the edge off.

No effects are passed on to the baby, but some women find that, after a while, it makes them feel light-headed and unable to concentrate on labour.

Diamorphine/pethidine:

These are strong pain-relieving drugs which are injected into the woman and take about 20 minutes to work.

The effects usually last for about two to four hours.

Some women find that they relieve the pain well and allow them time to rest, but others find they make them feel nauseous and dizzy.

The effects of the drugs, such as drowsiness, can be passed on to the baby, but an antidote can be administered to the baby as soon as it is born.

Epidural:

This is a type of local anaesthetic which numbs the area around the pelvis and can provide complete pain relief.

It is administered by an anaethetist via an injection into the the space between the woman's vertebrae.

It takes about 40 minutes to be set up and for the effects to begin to work and can either be administered continuously or topped up at regular intervals.

However, it is generally not administered or topped up towards the end of labour when the womb has opened fully and the time has come for the mother to push the baby out.

This is because the mother needs to be able to have feeling in the pelvic area in order to know when to push.

Disadvantages include a heaviness in the limbs which may need to be supported to avoid later backache, the need to have a catheter fitted, the need for a drip because the procedure causes the blood pressure to drop, inability to move from the bed and the need to be hooked up to a foetal heart monitor.



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