Painless Delivery

• Labour and childbirth is usually a painful experience and women vary in their response to it.

• Some women are keen to avoid drugs or other medical interventions while others are happy to consider all available options.

• For a woman having her first baby, the experience of labour (and her reaction to it) is unpredictable.

• For this reason, it is a good idea to be aware of the options for pain relief that are available and to know something about the different methods.

• You may have a plan for how you hope to manage your labour, but it is best to be prepared to be flexible.

Non-medical pain relief options for childbirth

• Research suggests that adequate preparation can help to reduce pain or at least modify the perception of pain and reduce anxiety, which can help you to better cope with labour. There are several non-drug pain relief options:

• Being in good physical condition is important. Exercise gently and regularly throughout your pregnancy, avoid cigarettes and alcohol, and eat a healthy, balanced diet.

• Knowing what to expect during the various stages of labour can help reduce anxiety. Antenatal classes are strongly recommended.

• Breathing techniques may help you to ‘ride the waves’ of each contraction.

• Using distractions like music can help to take your mind off the pain.

• Hot or cold packs, massage, a warm shower or immersion in a warm bath, and keeping active may all be helpful.

Epidural anaesthesia

• Epidural injections are the most effective pain relief available.

• They are used for vaginal births and also for caesarean sections, because they allow the mother to stay awake and alert during the baby’s birth.

• Anaesthetic is injected into the lining of the spinal cord through the back, which makes the mother feel numb from the waist down. Your baby’s heart rate will be monitored continuously.

• Possible side effects and complications of epidural anaesthesia include:

• The anaesthesia may not be complete and you may still experience some pain. This may require the procedure to be repeated.

• After the epidural has been inserted, your blood pressure may drop, causing you to feel faint and nauseated. This may also cause stress to your baby. This is treated by giving intravenous fluid.

• An epidural often causes some muscle weakness in the legs, so women who have had an epidural anaesthetic may be confined to bed.

• The lack of sensation in the lower body means that you will not be able to tell when you need to urinate. A urinary catheter will be inserted in most cases.

• Epidurals can lengthen the second stage of labour.

• The likelihood of having a normal vaginal delivery is reduced.

• If you are unable to push effectively, due to altered sensation and reduced muscle strength, the baby may have to be delivered by forceps or vacuum cup.

• Around one per cent of women experience headache immediately following the procedure.

• Some women experience itchiness after having an epidural. This can usually be effectively treated using antihistamines.

• Some women experience pain or tenderness where the epidural was injected.