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What types of pain relief can I get when having a baby?
There are many natural and medical ways to help manage your pain when you are in labour. Some people feel that it is important to them that their birth is as natural as possible, and some people will consider pain relief.
Non-medical pain relief includes methods such as relaxation, active birth, massage, heat or water. Other non-medical pain relief includes devices or techniques such as TENS (transcutaneous electrical nerve stimulation), water injections, and alternative and complementary therapies such as acupuncture or acupressure. Non-medical pain relief is used during labour either by itself or with medical methods.
Medical pain relief involves medicines to help you manage your pain during labour and delivery. One of the most common types of medical pain relief is nitrous oxide gas (also known as ‘laughing gas’), which you breathe in using a mouthpiece or mask. Other medicines include injections of pethidine or morphine, and epidural pain relief. An epidural is a procedure where a small amount of an anaesthetic is injected into your back, reducing your feeling of pain from your waist and down. A tube is then left in your back so more anaesthetic can be added over time.
What should I consider when choosing pain relief?
Pain-relief preferences during labour and delivery are personal. They may be influenced by your background, culture, tradition and religion. However, there are some practical things to think about when forming your birth plan. It is important to make sure that your pain-relief choices are available where you plan to give birth. For example, a water birth requires a birthing pool, which is not available at every birthing unit. If you are planning a home birth, you will not be able to have an epidural, which requires highly specialised doctors. You may also want to think about the cost of different types of pain relief and whether current COVID-19 restrictions make some options less feasible.
Some medical conditions can affect which pain-relief methods you use. For example, if you have HIV, hepatitis B or hepatitis C, you should not use a pool for labour or birth. If you are not sure if you have a medical condition that may affect your pain-relief choice, ask your doctor or midwife. If your baby is born well before your due date, or if you are past your due date, this may also affect the types of pain relief that you can use.
What pain-relief preferences should I have in my birth plan?
Your birth plan should include your pain-relief preferences during labour. Make sure your plan has enough detail, so that your care team and anyone coming with you into the labour ward can understand your wishes and know how to support you.
For example, if you would like to use massage, consider if you would like your birth support partner to learn how to massage you or if would you prefer a masseuse.
If you are not sure about what pain-relief options are right for you, you can learn more in an in-person or virtual antenatal class.
What if I change my mind during labour?
It is not unusual for mothers to change their birth plan during labour. This might be because their labour experience is different from what they were expecting, or because of the mother’s or baby’s medical needs. If you change your mind during labour, you should tell your support people your wishes so that they can help you.
It is not always possible to change from one type of pain relief to another during labour. For example, you cannot give birth in water for at least 4 hours after you have had some types of medicines for pain relief.
If you think you might want to change your birth plan during labour, it may be helpful to plan as broadly as possible. This could be by learning what pain relief is or isn’t available at the place at which you plan to give birth, or by learning about pain-relief techniques and how to use them, even if they are not a part of your ideal birth plan. Planning broadly can also save you the disappointment of not being able to stick to your birth plan if the birth doesn’t go as expected.
