Sunday, 10 May 2015
Pain relief in labour
Even if you plan to have a natural delivery, it is good to keep in mind the medical pain relief available to you, just in case you need other options when labour starts.
Gas and Air
It is a mixture of nitrous oxide and oxygen and is inhaled through a mouthpiece or a facemask. You can control how much you have and it helps you to establish a breathing pattern. Gas and air works by numbing the pain centers in the brain and dulling the pain of the contraction. You will feel light-headed and floaty, but you will still feel some pain. It is perfectly safe for you and your baby, and you can use gas and air alongside other methods of pain relief. If you are planning a home birth, your midwife can bring gas and air cannisters to your home.
Disadvantages of gas and air, are that it can sometimes make you feel nauseas.
Pethidine or meptazinol are narcotic drugs which once injected, induce drowsiness and help to reduce the pain. They take roughly 20 minutes to work and can last for three to four hours, when you may need another dose. They work by stimulating receptors in the brain and spinal cord, which dull the messages telling your brain you are in pain. The advantages of these drugs are that they are quick to administer, usually just an injection in your bottom or thigh, and are available at most maternity units. They also help to relieve tension and anxiety, so if you feel particularly stressed, it might be a good option.
Disadvantages of pethidine, are that the drugs can cross through to the placenta which can make your baby drowsy after birth. For this reason it isn’t advisable taken too close to delivery. You will also become very drowsy and perhaps not able to move about so much, which can in turn, slow down labour.
The nerves from your spine to your lower back pass through an area in your back called the epidural space. An epidural works by injecting an anaesthetic drug into this space at the small of your back, which blocks the nerve messages and causes numbness from your bump downwards. You won’t be able to feel any contractions, and an epidural won’t affect your baby in any way. An epidural can be useful if you are suffering from high blood pressure, as it can bring the pressure down.
Disadvantages of an epidural are that it has to be administered by an anaesthetist, who is not always available at short notice or in the middle of the night. If you are thinking about having an epidural, tell your midwife when you are admitted, or as soon as you decide to have one.
Other disadvantages are that you must be very still when your back is being injected, which can be tricky if you have a contraction. Movement is totally restricted once the epidural starts to work, and this can slow labour down, so a drip may be needed to speed things up again. For this reason you may also have a catheter fitted, as you won’t be able to walk or move around much. You won’t feel any contractions so you will probably be told when to push, which can increase the chances of a forceps or ventouse delivery.
Some women find that an epidural numbs only one side of their body or only a small part of their tummy. An epidural works differently for all women and may need to be topped up.
There is also a risk of a severe headache if the needle accidentally pierces the sheath around the spinal cord. This can be fixed once your baby is born by a procedure which seals the hole made by the epidural needle.
You can feel very out of control with an epidural because you have no feeling in your body, you cannot feel contractions and the midwife or doctor will tell you exactly when to push or not too.
Despite these disadvantages, an epidural is one of the most effective forms of pain relief.
They work in much the same way as epidurals, but the anaesthetic is injected into the fluid surrounding the spinal cord. They have been increasingly popular for use in caesarean sections or emergency obstetric procedures because they work very quickly – almost instantaneously. The spinal block only lasts for an hour or so, so it is not long enough to provide pain relief throughout labour.
Disadvantages are that similarly to the epidural, an anaesthetist is required to administer the drug; so one has to be available. Most women have to have a catheter fitted during and after the procedure because movement will be restricted and a spinal block takes about five hours to wear off.