Pain relief during labour and information about having a water birth – Leeds Maternity
Your midwife will advise what form of monitoring is best suited for you.
Every labour for every woman is completely different, and every woman has different coping mechanisms and different pain thresholds. What works for one woman would not necessarily be the right choice for another woman. The aim of pain relief is relaxation, and believing in yourself cannot be underestimated. If you believe you can do this, then you will do this.
We have varying forms of pain relief on offer. Having a warm bath and taking regular paracetamol is always good to aid relaxation. It is important to inform staff of any paracetamol and the doses you have taken at home. TENS machines can be sourced externally if you wish to try them. TENS works by transmitting a gentle electrical stimulation through the skin. You tend to feel this as little pins and needles in your back. This works by stimulating the body’s natural painkillers, endorphins. Stronger forms of pain relief may be available for a home birth, and it is important that you discuss this with your midwife.
Contractions are one of the weirdest pains you will ever experience, as they are very intense when they come but then wear off, and you get a break in between them. At the end, you’ve got a beautiful baby. Entonox is widely available for labour. Entonox, or gas and air, as it is also known, is breathed in using a mouthpiece. Gas and air can take about 20 seconds to take effect, and it is important you breathe it deeply as soon as you start feeling your contraction, through the duration of your contraction. You’ll be at the maximum effect of the gas and air at the peak of that contraction. Gas and air comes out of your system very quickly once you start taking breaths of fresh air. Gas and air really helps you focus on your breathing, which can be very difficult sometimes when you’re in a lot of pain.
Injectable pain relief or opioids are known as diamorphine or morphine. These drugs are injected into a muscle, either in your thigh or your bottom. Sometimes opioids can make you feel a little nauseous and sick, so we tend to give them with an anti-sickness injection. Opioids are very strong painkillers that make you feel very relaxed. They will not take the pain away, but you are far more relaxed throughout your labour. If you have an opioid injection, gas and air can also be used if needed for the contractions. Because the injections make you feel sleepy and relaxed, they can also have that effect on the baby. This is why we don’t like to give it too close to delivery, as it can sometimes delay the baby’s interest in feeding and make them a little bit slow to breathe to start.
Another form of pain relief is an epidural or regional anaesthesia. The effects of an epidural are very individual. Some people experience very numb and heavy legs, and some people can have full movement of their legs. However, we would not recommend getting out of bed if you have an epidural sighted. If you are wanting an epidural, it is important to note that you will need to receive a brief period of continuous monitoring. During active labour, it is really important that your bladder remains empty. This can be very difficult when you’re in labour, as the position of baby’s head means you don’t necessarily feel that you need to empty your bladder. If you are unable to empty your bladder, your midwife would recommend the insertion of a catheter to empty your bladder and then remove the catheter. This is to avoid any permanent damage to your bladder. An epidural can last the whole duration of your labour, and once the baby and placenta have been delivered, we would turn off the infusion pump and remove the catheter from your back. It can take up to a couple of hours for full sensation of your legs to return.
Water births can provide excellent forms of natural pain relief. Pools can be hired privately if you are wanting a home water birth. We have two water pools available at St James’s and three birthing pools available at LGI, so the likelihood of one being available is high.
Water births are really relaxing and create a beautiful environment. The lights in the rooms are quite dim, we have battery-operated tea lights, or you are more than welcome to bring your own battery-operated tea lights to use. Entonox or gas and air can be used whilst you are in the pool. While you’re in the pool, the midwife still needs to monitor your contractions and baby’s heartbeat. If a vaginal examination is needed, it can be performed in the pool, but sometimes this may be difficult, and you may need to get into an uncomfortable position. For this reason, it may be recommended to get out of the pool for an examination to occur.
It’s personal preference what you wear in the pool. You can choose to be naked or wear a bikini top or a vest top – it is your choice. At the time of delivery, you can choose to get out of the pool to deliver your baby, or you can remain in the pool to deliver your baby and your placenta. If you choose to deliver the baby and placenta in the pool, we would recommend a physiological third stage of labour where no injection of hormones are given.
Sometimes, following a water birth, the huge cry that we associate with a baby being born can be delayed. This is because the baby is not stimulated by the cold air once it is born. Instead, it is born into water that is of body temperature, and that stimulation to breathe can sometimes be delayed. A water birth can increase the risk of you sustaining a deep perineal tear that may involve your back passage. It is therefore recommended that you commence perineal massage at around 34 weeks of pregnancy to help reduce this risk.