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How to cope with childbirth pain

A new study has found that women choosing to have an epidural during child birth are 40 per cent more likely to need intervention with medical instruments.

But what are the options open to mothers when the contractions begin?

Midwife June Cox from Tommy's Baby Charity and Phillip Steer, Professor of Obstetrics Chelsea & Westminster, give their expert advice on the treatments available...

PAIN RELIEF

Epidural

An epidural is a local anaesthetic that numbs all sensation from the waist downwards.

It's a high-tech procedure and has to be administered by an anaesthetist so must be given in a hospital.

"The advantages of the epidural is that it works, and is the only method that works reliably. About 98 per cent of women get some pain relief," said Professor Steer.

"The risks are very rare. One of them is low blood pressure. It can also make it difficult to push, if they are not feeling the same primeaval urge."

This may lead to the use of medical instruments such as forceps to aid delivery.

Those with heart problems may be advised to get pain relief as this reduces the stress on the heart.

Gas and air (entonox)

Gas and air is administered through a mouthpiece or face mask. You hold the mask yourself and let go of it once you start to feel lightheaded.

Tommy's midwives say the advantage of this relief is that it can be used at any time during labour and does not affect the baby.

However, as it is a mild painkiller it doesn't completely remove the pain, according to Tommy's, it just "takes the edge off it".

Professor Steer also added that it can be used to help distract women during the few minutes of each contraction.

Pethidine

Pethidine is a morphine-like drug that was used a lot in labour before epidurals took over.

It works to alter your perception of pain and is more of a sedative than a painkiller. It is administered as a shot every three to four hours.

Pethidine is not a very popular option for women in labour.

"Few people like it as it makes some people feel sick and rather drowsy," Professor Steer said.

June Cox added that pethidine can pass through the placenta to the baby making the baby drowsy and sluggish at first. They may need to be given an antidote to the pethidine.

RELAXATION TECHNIQUES

Breathing

The National Childbirth Trust (NCT) advises breathing steadily in through the nose and out through the mouth while focussing on the out breath.

When contractions speed up it is important to stay focussed on the breathing and not allow your thoughts to wander.

Visualisation

The NCT suggests imagining the baby is moving down and your cervix is opening like a flower to help it on its way. Or to imagine the pain as a spot of colour, and as you breathe out to wipe it away with a different colour.

COMPLEMENTARY THERAPIES

Aromatherapy

Aromatherapy oils are commonly used in massage and research has shown that aromatherapy can help reduce anxiety and fear and help the woman cope better with labour.

However, June Cox said: "It is important to talk to a qualified practitioner who knows which remedies are safe to use during labour."

Other therapies include self-hypnosis which is a form of deep relaxation. Studies have shown that it may increase a woman's satisfaction with her labour. Herbalism and homeopathy can be used for the labouring woman but must be prescribed by a qualified practitioner.

Be prepared for a change of plan

Whichever options you choose you should be prepared for your plans to change.

Professor Steer said: "It can be difficult to predict what will work. Some women work away at these techniques and seem very relaxed but in labour they fall to pieces and sometimes need the pain relief.

"Other women are worried about coping and say: 'Will I cope? Will I cope?' And when it comes to it they're fine."

For more pain relief options visit the National Childbirth Trust website.

Tommy's Baby Charity also offers advice on their website. They have a pregnancy information line staffed by midwives for any pregnancy query on 0870 777 30 60.