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Managing Labour Pain

The powerful contractions felt during labour result in varying levels of pain.  Like all the other physical changes experienced during pregnancy, labour and birth, the pain that is felt during labour is there for a purpose.  The body has a natural response to pain, and produces endorphins to help protect the mother from excessive pain, and also to help her labour and birth effectively.

How painful will labour pain be?

Think about labour pain being:

  • Purposeful

  • Anticipated

  • Intermittent

  • Normal

 

Purposeful:  It brings about the birth of your baby.

Anticipated:  since you know to expect pain in labour you can prepare yourself by learning pain management skills.

Intermittent:  labour pain is not continuous.  There will be a break between contractions to rest.  During the final stages of your labour, the contractions may seem to come on top of one another – your birth partner can help you let go of that contraction and relax briefly before the next one comes.

Normal: in most cases labour and birth are normal processes.  Labour contractions are healthy, powerful sensations.

 

Ideas to help cope with the pain

  • Try to think positively.  Listen to stories and read facts that will increase your confidence.  Ask for information, express any concerns to knowledgeable people during your pregnancy and labour.

  • Supportive birth partner:  someone who cares for you and will share a positive attitude and will help you to maintain yours.

  • Making sure that you can move round freely during your labour.

  • Practice pain management skills.  massage, relaxation and rhythmic breathing can be used during pregnancy and labour.  Learning these skills can increase your confidence in your ability to labour and these skills can help you deal with tension and stress throughout life.

  • Make sure that you are well nourished and well rested before you go into labour.  Everything hurts more and we are less able to cope when we are tired and hungry.  Make sure that you take care of your physical and emotional needs in the weeks before labour begins.

  • Make sure that your birth environment is right for you as possible:  low light, music, scented room spray etc.

  • Know your options for medication and pain management.

  • Talk to your birth partner and prepare.  Plan the things that they can do to help you cope with your labour.

 

For more information about methods of pain relief please refer to your Pregnancy Information Booklet (PDF document, link opens in new window).

  

Natural Methods of Managing Labour Pain

Deep relaxation and use of breathing

Using relaxation techniques such including breathing techniques, visualisation, self hypnosis, and hypnobirthing are effective ways of managing labour pain naturally.  They have also been linked to a reduced risk of assisted birth or caesarean section. 

Rhythmic breathing during labour will maximise the amount of oxygen available to you and your baby. Breathing techniques can also help you to handle contractions and be more satisfied with how you've coped with your labour.

Try closing your eyes for a moment. Focus on your breathing, and notice how rhythmical it is. You breathe in, then there's a slight pause before you breathe out. Your out-breath should be slightly longer than your in-breath, and you pause slightly before your lungs draw the next breath in.

If you would like to know more about how relaxation techniques can help you, book onto our birth and relaxation class  link to parent ed page.

 

Use of water / water birth

The use of water for relieving pain in labour has been found to be advantageous. The warm water helps you to relax and has therefore been found to shorten the labour and reduce the need for other forms of pain relief. The freedom of movement is also a great advantage.  You are the first person to touch your baby.

Benefits to the baby are thought to be that less pain relieving drugs are used and the transition to the outside world is less traumatic.

Main benefits of using water...

  • The majority of women using a birthing pool find that the warm water encourages and enables them to relax more.

  • Relaxing and reducing stress allows a woman’s body to release more of the hormone oxytocin which stimulates contractions and dilates the opening of the womb.

  • If a woman in labour becomes less stressed and more relaxed, she will increase the production of endorphins, which are her body’s natural source of pain relief, and reduces the need for other forms of pain relieving drugs.

  • Reduces the need for an epidural.

  • The buoyancy of the water allows a woman to change position more easily and therefore maintain a good flow of blood through the placenta to her baby.

  • Women who use a pool report higher levels of satisfaction and control.

  • Babies born in water experience a more gentle transition from the womb when delivered into warm water.

  • Allows you more control over your body and labour.

  • Gives a peaceful and relaxing atmosphere.

  • Less intervention required.

 

TENS

This stands for Transcutaneous Electrical Nerve Stimulation. Electrodes are taped onto your back and connected by wires to a small battery-powered stimulator.

TENS works by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals that are sent to the brain by the spinal cord.

TENS machines can be hired from many pregnancy-related retail outlets for use at home.  It is recommended that you start using the TENS machine in the early stages of labour to feel the full effects.  However, if you do not have a TENS machine at home, we do have TENS machines in the hospital for you to use in established labour.

 

Advantages of TENS

  • There are no known side effects for you or your baby.

  • You control the strength of the current.

  • You can be mobile and upright

 

Please note, the TENS machine cannot be used in water.

 

Gas and Air (Entonox)

This is a mixture of oxygen and nitrous oxide gases. Gas and air won't remove all the pain but it can help to reduce it and make it more bearable. Many women like it because it's easy to use and they control it themselves. It is breathed in via a mouthpiece or mask which you hold yourself.  The gas takes about 15 to 20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.

Side effects

There are no harmful side effects for you or the baby but it can make you feel light-headed. Some women also find that it makes them feel sick, sleepy or unable to concentrate. If this happens, you can stop using it.

Advantages of Gas and Air

  • It is easy to use and quick to start working.

  • You can control it yourself and stop if you don’t like it.

  • You can use it at any time during established labour.

  • It can be used while you are in water.

  • It has no harmful side effects to the baby.

 

Pethidine or Diamorphine Injections

Another form of pain relief is the intramuscular injection (into the muscle of your thigh or buttock) of a synthetic morphine based drug, such as pethidine or diamorphine. The injection can also help you to relax, which can lessen the pain.
It takes about 20 minutes to work after the injection, and the effects last between two and four hours.

There are some side effects to be aware of:

  • It can make some women feel woozy, sick and forgetful. 

  • Pethidine can cross over the placent to the baby

  • If it hasn't worn off towards the end of labour it can make it difficult to push. You might prefer to ask for half a dose initially to see how it works for you. 

  • If pethidine or diamorphine are given too close to the time of delivery they may affect the baby's breathing.  

  • Babies whose mothers have had pethidine in labour may feed less frequently in the first 48 hours as it can make a baby drowsy for several days.

  • You cannot use the pool for around 4 hours after pethidine has been given (or until the effects of pethidine have worn off fully).

 

Epidural

An epidural is a method of pain relief for labour, which involves administrating drugs through a small tube inserted unto the middle of the back in order to anaesthetise the nerve endings.  Any woman wishing to have an epidural will need to be on the Consultant-led Labour Ward.

The epidural will be sited by an Anaesthetist.  They will come to see you and answer any questions you may have.  It usually takes about 20 minutes to set up the epidural and 20 minutes to work.

You will need to have a drip in your arm so that fluids can be given.  We also insert a tube into your bladder (catheter) to keep your bladder empty.

You will not be able to walk around with an epidural, however the midwife will help you to find the best position to be upright as possible to encourage baby’s head to navigate down the pelvis.

 

Advantages and Disadvantages of Epidural

Advantages

  • Epidurals provide the most effective method of pain relief in labour and can be used to provide pain relief over hours.

 

Disadvantages

  • Restriction of movement, restricted to the bed for labour and birth.

  • Need to have a catheter and intravenous fluids.

  • Occasionally the epidural may only numb one side of, or part of the body.  It may be possible to re site the epidural to resolve it.

  • The second stage of labour may be prolonged as epidurals reduce the urge to bear down or push.  This is linked to an increased risk of delivering your baby with a ventouse or forceps.

 

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