Pain Relief during Labour - Will I need Pain Relief?
What are your options for Pain Relief in Labour?

Entonox (Gas and Air)

This is the most common form of pain relief used routinely in both hospital birthing suites and for homebirth. (the midwife or doctor will usually bring it with her).

It is basically 50% Nitrous Oxide (laughing gas) and 50% air (oxygen, nitrogen, carbon dioxide etc)

The benefits of gas and air are that although it does cross the placental barrier to the baby the effects are very short lived and therefore there are not known to be any serious side effects with its use for the baby.

However with gas and air there is about a one minute time lag between starting breathing it and the gas having any effect. This means that if you start breathing it when the contraction starts you will not actually get the benefit of the gas for that contraction as they only generally last a minute or so.

Nitrous Oxide is also a sedative so it can make you feel very woozy and dizzy. It can also make you feel very nauseous and given that women often feel sick during labour anyway you may feel that you would want to use another method other than gas and air. The nice thing about gas and air is that you control it so you can simply choose not to use it anymore if you do find it unhelpful.

In randomised clinical trials no difference has been shown between the pain relief received from simple compressed air or Entonox. This probably means that most of the effect is related to a placebo response.

However women do generally report satisfaction with it use. If you use the Second Nature Birth Programme® you will be less likely to need Entonox.

Opiate based pain killers (Pethidine)

Opiate based pain killers are related to morphine. They are falling out of favour in the west because they cross the placental barrier to the baby. They are effective as pain killers but they do have some unwanted side effects. They affect the breathing of the mother and the baby and are sedative, so both mum and baby will often appear very sleepy. Because this is not really conducive to a healthy birth (a sedate mum won’t feel like getting actively involved in the birth), forceps and Van Tooze interventions for vaginal delivery may well be employed (these are described in the next section on Surgical intervention). This is far from the natural birthing experience that most women hope for and these methods of assisted delivery can lead to increased perineal trauma.

Babies born after the mum has had pethidine are often very sedate for several days after the birth and a big disadvantage is that they do not readily breast feed which can be distressing for the mother and partner.

Although all mothers and babies do not experience these side effects you may wish to consider the risk/ benefit ratio before allowing pethidine to be administered.

The amazing thing about the human body is that it already creates a naturally occurring opiate type pain killers which will work well when it is allowed to. They are incredibly potent (200 time stronger than morphine and the are called endorphins. Using the Second Nature Birth Programme® will help this hormone work effectively as it was meant to. See the above link for more details.

Epidurals

There is a growing feeling in the west that an Epidural is the easy option for pain relief during birth. It is certainly true that if you choose an epidural for your birthing these will be no discomfort at all because the lower half of your body will be anaesthetised. For some women this may well be a valid solution for a situation that at first seems frightening and scary.

Opting for a certain outcome may have many attractions and if this is what you have decided for your birthing it is very understandable. Additionally if epidurals are given too early in labour it can precipitate a very medicalised birth experience where control of your body and your experience is adicated to somone else. There are very few experiences in life where we would want this for ourselves so why do so many women opt for this option in childbirth? We belive the answer is FEAR. Fear of pain, fear of the unknown and fear the perception of lost dignity. These are all understandable but if you read the testimonials from women who has used hypnobirthing you will see that a natural birth can be a more rewarding experience for you and your baby.

Many women however, want to have the natural birthing experience. They want to experience what it is like to give birth to a much wanted baby, and they value the sense of control and achievement that they get from a natural positive birthing experience. It is after all the most natural thing in the world to give birth, and it is what 85% of women are able to do without any medical intervention what so ever.

It is what the female human body has evolved over hundreds of thousands of years to be able to do. It is therefore perhaps a shame that many women decide to abdicate this experience out of fear and the uncertainty that they feel about their own innate ability to give birth. Our feeling about epidurals is that they are incredibly valuable when medically indicated, or if a women really has uncontrolled anxiety around birth then they are a very valid option. At the end of the day the only aim for any birthing should be a healthy mother and baby so if you really feel an elective epidural is right for you then it is your choice and no one has the right to make you feel guilty about your choice of birthing method.

One aspect about epidural that is often overlooked is that because you loose all sense of feeling around the vaginal and perineal area there is more potential for trauma to the perineum. Episiotomy is more common in epidural births. Because the area is numb, there is less perceived need to avoid an episiotomy by the midwife or obstetrician.