This page is designed to make you aware of the different coping mechanisms that are available to you during labour. It will explain what the different choices are and any advantages or disadvantages that there may be. Every woman鈥檚 experience of labour and childbirth is unique, and each woman will have individual preferences and coping strategies. It is hoped that this leaflet will provide you with information to help you make an informed decision about your choices in labour. You are able to ask your midwife for advice and support at any time during your labour.
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Breathing & Relaxation Technique听听
A slow, deep, steady breath can help to release tension, reduce听pain听and increase feelings of relaxation. When you feel a contraction build, breathe out to empty your lungs, then, continue to breathe slowly and rhythmically for the duration of the contraction. Try to keep your shoulders soft and relaxed. You can breathe through your nose or your mouth; choose whatever you find more comfortable. It is beneficial to take some time out during your pregnancy to practice breathing techniques and find a method that works well for you.听听
You may find massage helpful during labour, especially if you have lower back ache. Your birth partner could massage your neck, shoulders or back during contractions. This can help to reduce tension and decrease discomfort. Massage can also be听a good way听for your partner to feel connected to you during your labour. Practice massage during your pregnancy; you may find that you听have a preference for听lighter or firmer touch massage.听听
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Hypnobirthing听听
Hypnobirthing is an approach to birth that uses breathing exercises, relaxation听techniques听and self-hypnosis. The aim is to help you and your partner approach your baby鈥檚 birth with confidence and to give you the tools that can help you both to remain calm and in control, whatever path your birthing takes.听听
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Transcutaneous Electrical Nerve Stimulation (TENS)听听
A TENS machine is a small, handheld device that sends electrical impulses through small, sticky pads on your lower back. It听isn鈥檛听fully understood how a TENS machine helps to reduce pain, but it is thought that it helps to block pain signals sent to the brain. It is also thought to help trigger the release of hormones called endorphins (your body鈥檚 natural pain killers) and it can act as a good distraction during contractions. It is thought that a TENS machine is more beneficial in early labour, so it may be helpful to hire one so that you can use it at home.听听
Advantages:听Non-invasive, has no side effects for mum or baby, you are in control of the machine, you听can remain mobile,听can be used at home if hired/听purchased, can be combined with hypnobirthing, gas &听air听or听pethidine.听
Disadvantages:听Cannot be used in the bath/pool,听may听not be effective pain relief in established labour听听
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Birthing Pool听听
When you are at home in the early phase of labour, you may find having a warm bath relaxing. The warm water helps to relieve tension, decrease pain and increase relaxation. When you come into hospital in established labour it may be possible to use the birthing pool. However, the birthing pool听isn鈥檛听suitable for all pregnancies and labours, please ask your midwife when you come into hospital in labour if this is a safe听option听for you and your baby. We have one birthing pool at 51猎奇 Hospital, please let us know when you ring up in labour that it is your preference to use the pool.听听
Advantages:听increases relaxation, can reduce the need for further pain relief such as an epidural, the water supports your body and allows freedom of movement to adopt the most comfortable position, you can use gas & air alongside the pool, being in the water doesn鈥檛 affect your baby, you remain in control because you can choose to get out at any time.听
Disadvantages:听It is not suitable for all women in labour 鈥� certain pregnancy or labour complications may mean that the birthing pool is not recommended, the birth pool may not always be available听
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Gas and Air (Entonox)听听
Entonox is a gas that听contains听50% oxygen and 50% nitrous oxide. It is inhaled through the mouth via a handheld mouthpiece that is replaced for every patient. You are in control of administering the gas and air. It is advised that you start to breathe in the gas and air as soon as you feel a contraction starting and you should continue to breathe it in until the contraction finishes.听听
Advantages:听It takes the edge off the pain, you are in control of the mouthpiece and breathing, encourages effective breathing through contractions, quick acting 鈥� the effects are felt within seconds, doesn鈥檛 affect听your听baby, you can stop taking it at any point and the effects wear off quickly,听it can be used alongside a TENS machine,听birthing pool,听diamorphine & epidural.听
Disadvantages:听It doesn鈥檛 get rid of all the pain, it may make you feel sick or dizzy, it can make your mouth feel dry (drinking to thirst and wearing lip balm can help), quick to wear off (this is helpful if you don鈥檛 like the side effects),听听
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Pethidine听Injection听听
Pethidine听belongs to a group of drugs called opioids. It is given as a single injection into the muscle in your thigh or buttock. Due to the side effect of nausea,听pethidine听is given with an anti-sickness medication.听听
Advantages:听You may feel like you can cope better with contractions, you may not feel the contractions as intensely, you may be able to sleep through contractions, it can help you to relax听
Disadvantages:听听Doesn鈥檛听take away the pain completely,听it听is an injection, it can make you feel sick (your midwife will give an anti-sickness with it), it crosses the placenta and may affect听your听baby.听Your听baby may be sleepy at birth depending on when the last dose was given. This may听also depend on how many doses you have had and how long before birth you had your last dose It is not recommended to go into the birth pool for four hours after听pethidine听is given听听
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Epidural听听
An epidural is an anaesthetic that goes into your back through听a very fine听catheter (tube). It works by blocking pain signals to the brain by numbing the nerves in your lower back. An anaesthetist will site the epidural for you.听Usually听an epidural provides听very effective听pain relief. Once the epidural is sited it will continue to provide pain relief until it is turned off after the birth. If you feel any discomfort, there is the听option听to top up the epidural to make you more comfortable. One of the side effects of having an epidural is that your blood pressure may become low and this can make you feel unwell. It is therefore recommended that you have intravenous access (a drip into one of your veins) so that it is possible to give you fluids if your blood pressure does fall to help you to feel better. You may not know when you need to open your bladder or feel able to, it may therefore be recommended that you have a catheter (tube into the bladder) sited to help keep your bladder empty during labour. It is also recommended that your baby鈥檚 heartbeat is听monitored听continuously for a minimum of 30 minutes after you have had the epidural. You will usually be able to get up and walk around approximately 6 hours after the epidural is stopped听听
Advantages:听It offers complete pain relief for most women, your mind stays clear, it takes approximately 30 minutes to complete the procedure and feel the effects, you may be able to sleep through contractions, the epidural should last throughout labour and birth, the epidural can be topped up and used for pain relief for instrumental births, caesarean sections or if you require any stitches after birth, it brings down high blood pressure听
Disadvantages:听You can鈥檛 walk around in labour and will be less mobile because you will have reduced sensation in your lower limbs,听it听may cause your blood pressure to drop which can make you feel dizzy and听nauseous, you will need intravenous access (cannula), you may not know when your bladder is full and so might need a catheter (tube into your bladder) to empty it, you will need to be monitored more closely in labour, you are more likely to have a longer second stage of labour (pushing phase) which may result in needing forceps or ventouse to help deliver the baby.听
A midwife is always available in the maternity assessment centre or on delivery suite to talk to if you need some advice or reassurance.听Single point of contact: 01423 557531, if you are unable to speak on the phone and need urgent care 鈥� please just attend maternity assessment centre (MAC)听First floor,听Strayside听Wing (follow the signs for Central Delivery Suite/Pannal Ward).听