Comfort measures and pain relief
All labours and births are different. Everyone deals with them in different ways, and there is no right or wrong way to cope with labour and birth.
Resources that can help you decide what is best for you:
Comfort measures and self help
Wherever you are planning to have your baby; at home, the blossom birthing unit, central labour suite or theatre, there are things you can do to help you feel relaxed, comfortable, safe, and calm.
RCM visual aids for birthing positions: https://www.rcm.org.uk/media/2313/rcm-a3-positions-poster-download.pdf
Hypnobirthing
Hypnobirthing involves using a mixture of visualisation, relaxation, and deep breathing techniques. It can provide you with the skills to successfully manage all types of births, including caesarean birth, induced labour, or situations that are unexpected.
Hypnobirthing uses knowledge of science-based birth physiology and self-hypnosis techniques to reduce the need for pain relief so that you can manage the sensations of labour.
Hypnobirthing has been shown to:
- Increase your comfort and relaxation during birth
- Reduce fear and anxiety around childbirth
- Allow you to feel in control during labour
- Give birth partners an active role to play during labour and birth
Useful Resources
Water
Research has shown that using water during labour and birth may help to:
- Increase relaxation.
- Increase comfort and mobility.
- Provide a secure, warm, private, quiet environment.
- Reduce pain and reduce the need to use other forms of pain relief including epidural.
- Increase perceptions of a positive birth
The use of the birthing pool is recommended for those with:
- An uncomplicated pregnancy and medical history.
- Established labour and a dilated cervix of 4cm or more.
- Less than 24 hours following any rupture of the membranes with clear fluid.
- A single baby in a head down position.
- No signs of infection.
- No use of opioid pain relief (pethidine, morphine, diamorphine or meptid) within two hours of entering the pool.
- A fetal heart rate within normal limits.
- Blood pressure within normal limits
- BMI less than 40
If you would like to use the pool but do not meet all the above criteria you should still discuss this with your midwife. They will be able to advise you of any risks, taking account of your own individual circumstances.
Useful Resources
TENS
TENS stands for transcutaneous electrical nerve stimulation. It’s a form of pain relief that you can control with a hand-held device.
A TENS machine works by sending mild electrical impulses to sticky pads on your lower back. TENS is thought to work as the electrical pulses stimulate nerves that run to the spinal cord and block the transmission of pain. Find out more: https://www.nct.org.uk/labour-birth/your-pain-relief-options/labour-pain-relief-tens-machine
Gas & Air (Entonox)
Gas & air (Entonox) is a mixture of oxygen and nitrous oxide gas. Gas and air will not remove all the pain, but it can help reduce it and make it more bearable. It's easy to use and you control it yourself.
You breathe in the gas and air through a mask or mouthpiece, which you hold yourself. The gas takes about 15-20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths. Find out more: https://www.nct.org.uk/labour-birth/your-pain-relief-options/labour-pain-relief-gas-and-air-entonox
Opioids - Diamorphine & Pethidine
Diamorphine or Pethidine are medications that are given via injection into your thigh or buttock to relieve pain. They can also help you to relax. Both take about 20 minutes to work after the injection. The effects last between 2 and 4 hours, so would not be recommended if you're getting close to the pushing (second) stage of labour. Find out more: https://www.nct.org.uk/labour-birth/your-pain-relief-options/labour-pain-relief-opioids-pethidine-and-diamorphine
Epidural
An epidural is a type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It should not make you sick or drowsy. In most cases, an epidural gives complete pain relief. It can be helpful if you are having a long or particularly painful labour. An anaesthetist is the only person who can give an epidural, and it is only available to have on Central Labour Suite. Find out more: https://www.nct.org.uk/labour-birth/your-pain-relief-options/labour-pain-relief-epidurals-and-combined-spinal-epidurals
Useful Resources
- Obstetric Anaesthetist’s Association: https://www.labourpains.com/Epidural-Information-Card
- Epidural video: https://www.labourpains.com/Information_Videos
Pain relief for caesarean birth
When giving birth by caesarean section you will either have a regional anaesthetic (where you stay awake) or a general anaesthetic (where you go to sleep). The Obstetric Anaesthetist’s Association have more information about these types of pain relief for caesarean birth: https://www.labourpains.com/assets/_managed/cms/files/New%20Leaflets/Labour-Pains-Caesarean-Section-Information-sheet-EN2.pdf