My Pain Relief Options in Labour

What pain relief options can I choose in labour?

“Labour” is aptly named and can be a painful process. At SHORE FOR WOMEN we recognise that every woman is different and every labour is different – how one woman copes with labour pains will not suit everyone. It is best to familiarise yourself with all your pain relief options ahead of time – keep an open mind, as labour is a dynamic process and your choices may change as the labour progresses.

Under no circumstances should women feel a sense of failure or defeat due to their pain relief choice. Platitudes such as “but you are doing so well without an epidural” or “well at least you got this far on your own” have no place on a modern delivery suite. You have a range of choices to help you:

Pain-relieving injections – these are strong pain-killers (such as morphine or pethidine) given as an injection into the woman’s bottom or arm. These medications do not affect the contractions but can sometimes make women feel drowsy or nauseated.

Inhaled nitrous oxide (Gas& Air) – the woman holds the mouth-piece and inhales this analgesic gas during contractions. It has a rapid onset and is very safe but can occasionally make women feel light-headed or nauseated or give a tingling sensation in the hands.

TENS (Transcutaneous Electrical Nerve Stimulation) is becoming more popular for pain relief, particularly in the early stages of labour. The woman buys or rents the TENS machine, which sends electrical impulses from a hand-held generator to electrodes placed on her lower back. TENS is safe, allows the woman to move around freely in labour and does not give any of the potential side-effects from pain medication in labour.

Natural pain relief options are helpful for women who wish to avoid pain medications. These options include maternal positioning, a birthing ball, breathing techniques, music, hypnosis and acupressure. Some women also get benefit from immersion in water, particularly in the 1st stage of labour, although delivery under water is not recommended.

Epidural anaesthesia is now the most commonly used option for pain relief in labour, especially for 1st time mothers. An epidural involves an Anaesthetist inserting strong pain relief medication in your lower back, which numbs you from the waist down and eases the pain of labour contractions.

Usually the woman sits on the side of the bed, her back is cleaned with antiseptic solution and local anaesthetic is injected to numb the skin. Once the skin is numb, a needle is inserted between the vertebrae into an area close to the spinal nerves. Strong medication is inserted into this area, which coats the nerves and begins to take effect within 10 minutes. A small tube is then left inside the area (and taped to your back) so that more medication can be given as the labour progresses.

Does an epidural carry any risks or downsides?

At SHORE FOR WOMEN we work with very experienced Anaesthetists and the risks are minimal.

  • Epidural makes a woman’s legs heavy and she cannot walk around during the labour
  • An IV cannula and fluids are needed before an epidural
  • Because the nerves to the bladder are numbed, a catheter may need to be inserted to prevent the bladder from overfilling
  • Women with an epidural have a slightly higher chance of needing an instrumental delivery, but the rate of caesarean section is not increased
  • 1% of women may get a bad headache in the days after delivery, as the spinal fluid can leak out following an epidural in labour.
  • Serious complications are very rare – you can discuss these with your Anaesthetist.
  • Mater Hospital
  • North Shore Private Hospital
  • The University Of Sydney
  • Royal College Of Obstetricians and Gynaecologists