GUIDE TO PAIN RELIEF IN LABOUR
Relaxation:
Relaxation is the most important tool for coping with the stress,
fatigue and pain of labour. Relaxation, or “letting go” is a physical and
mental state and you can learn specific skills during your pregnancy that will help you
to cope in labour and later when you have a new baby in the house
Breathing can be used to release tension in labour and help maintain a relaxed state.
The rate at which you breathe is an individual one, but try to breathe as slowly as you
can at all times. There is no need to learn how to breathe in labour - you already know
how to do this and your body will automatically adjust the rate as needed. As your
body requires more oxygen and energy, so you will breathe a little faster.
If you are having trouble slowing down your breathing, try to memorise a very simple
song or a nursery rhyme, as this will help you to control your breathing much more
Touch and Massage:
Learn to relax towards your partner’s touch. If they see that you are tense in a
particular area, your partner places their hands warmly and firmly over the part that
is tense, then gently strokes from the centre of the body out to the edge, so that
the tension flows out and away. Let yourself go at your partners touch, so that you
are working together as a team. Pay particular attention to areas where tension is
commonly felt: the neck, shoulders and back. The face often shows signs of tension
during labour, so practise gently touching on the brow and at the side of the eyes
There are a number of areas where firm massage can help relieve the pain and
tension in labour:
Sacral massage: this can be done most effectively when you are leaning into
something. Your partner places the heel of their hand into the small of your back and
applies firm pressure in a small circular motion. This can be effective during the build
up to a contraction.
Thigh massage: this is useful for cramps, fatigue or shaking in labour. Your partner
places their hands at the top of either your thighs, or your calves and with long
flowing strokes runs their hands down the entire length of your legs, right to the tips
of your toes!
Remember to keep the strokes long and slow, and keep your hands on your partner
throughout the massage
Massage is effective during pregnancy as well, and it is good to practise before
labour, you may wish to use some oils (such as sweet almond or grape seed oil) to make
the massage easier.
Varni Achary
Page 2
Hydrotherapy:
A combination of water and heat is very useful for promoting a relaxed state. A hot
bath or shower will help reduce backache in pregnancy or labour. Local application of
heat (flexible hot packs, or well wrung out hot, wet compresses) feels good on smaller
sore areas, usually the lower back. Try these if you suffer from abdominal aches
during pregnancy.
TENS:
Transcutaneous Electrical Nerve Stimulation is a popular form of relieving pain during
labour, particularly in the early stage (1st stage of labour = thinning and dilatation of
the cervix). It works by stimulating your body’s own pain relieving mechanisms. Also,
there are no side effects to either you or your baby.
Four electrodes are placed on your back so that the nerves supplying your womb, the
pelvic organs and the muscles around your pelvis can be stimulated, by a weak pulse.
The small electronic unit attached to and feeding the four electrodes will allow you to
remain mobile during labour. TENS can be used very early in labour, and indeed, some
women report effective pain relief from TENS through the labour, if applied early
enough.
TENS machines are available to hire from certain pharmacies. Since it is best used in
early labour, and therefore at home = it is advisable to ensure you have it early
enough, and that you are comfortable and sure of how to apply and use it.
Entenox (Gas & Air):
This is often the first line of pain relief given to you by your midwife. It is a mixture
of nitrous oxide and oxygen, sometimes called “laughing gas”; you may have already
used it at the dentists! It is given to you via a mouthpiece, which you breathe
through. The pain relief is immediate but short lived. Your midwife will direct you to
breathe throughout your contraction: Long, slow breathing. The extra oxygen you
take on will also help your baby to cope with the contractions! It can make you feel
light headed and dizzy, as if you have had one drink too many, and so it is important
to use it just for the contractions. In between make sure you get lots of fresh air.
Entenox may not take the pain of labour away, but will make it more bearable and
could help you to relax.
Varni Achary
Page 3
Pethidine:
This can be a very effective form of pain relief in labour. It is administered by a
midwife as an injection through your vein. Pain relief can last about three hours but it
can be repeated if necessary. A side effect of pethidine is nausea and vomiting, (this
affects only some people and will pass): to counteract this, an anti-sickness drug will
be given alongside the pethidine. It will also make you drowsy, enabling you to get
some rest during the labour. It can also make the baby drowsy, and for this reason
your midwife may not give it to you when you are very close to delivery. This period of
drowsiness will pass, but an antidote is given if there is any concern at birth. Like
Entenox, pethidine may not take away the pain completely, but it could help you to
cope and relax in labour.
Epidural:
An epidural is a method of analgesia that will take away most, if not all, the pain of
contractions during labour. This has to be set up by an anaesthetist Administering an
epidural is more complicated than giving you a pethidine injection, and may take up to
30 -45 minutes before you gain any pain relief, but once in place your epidural can be
“topped up” by your midwife, so that you remain comfortable through the rest of your
labour. The epidural we give to you in labour will numb only the area from the top of
your womb to the very tops of your legs. This means you will still have some mobility
during your labour and full power to your legs and, to enable you to push at the end!
The drug given to you via your epidural tends to drop your blood pressure; to
compensate for this you will need a drip in your arm for the duration of your labour.
We may also need to monitor the baby more closely, though the epidural does not
directly affect your baby.
Prolonged episodes of continual “topping up” of your epidural may make your legs
heavy: For your comfort and to allow the baby’s head to drop, your midwife will pass a
urinary catheter to drain your bladder. Your legs will recover afterwards.
Sometimes, the sensation to bear down when pushing may be considerably dulled; on
these occasions the midwife will feel your contractions and direct you to push. In
most cases, you can feel the urge to push, an epidural will help you to control it, and
make your pushing more effective. More people with epidurals have normal deliveries
than any other type of delivery.
It is no more likely than a non-epidural delivery to give you a backache, though you
may notice local tenderness where it went in for a day or two. At this hospital there
is a 1 in 500 chance of your getting a bad headache after an epidural. If you do, it can
be put right. Some women experience itching whilst having an epidural, we will try to
make you more comfortable and this will pass.
Varni Achary
Page 3
Complementary therapies:
Women are increasingly choosing complementary therapies as alternative methods of
enhancing their experience of pregnancy, labour and delivery. However, it is
important to get advice on their uses and applications by qualified professionals from
a recognised body, who will be best, placed to advise pregnant women on their
specific needs.
Here are a few of the most commonly used therapies:
Acupuncture
The stimulation of particular points on the body using special needles to enhance a
flow of energy or “chi” along pathways called meridians.
Aromatherapy
The use of essential oils to stimulate, refresh, soothe and heal. During pregnancy and
childbirth it is associated with reducing stress and relieving pain.
Homeopathy
Uses a variety of plants, minerals and salts in extremely diluted form to cure and
treat a range of conditions and symptoms, according to the Law of Similars.
Hypnotherapy
A state of concentration which when combined with relaxation allows a heightened
state of awareness caused by suggestion.
Osteopathy
Involves manipulation of the spine, other joints and muscles to treat the body’s whole
mechanical system.
Reflexology
The “reflex zones” on the feet which correspond with different parts of the body,
are massaged in order to help increase blood circulation and relax tension.
Shiatsu/Acupressure/Therapeutic touch
Massage and the application of pressure, which has been shown to increase levels of
the body’s endorphin, but are also felt (as in acupuncture) to enhance the flow of
“chi” along meridian pathways.
Varni Achary
Page 5