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Every labour is different and its pattern and progress is difficult to predict. The midwives and doctors hope to support you as much as you need through this process, this includes providing a wide variety of pain relief options.
Your midwife and/or doctor will discuss pain relief with you and your birth partner as labour progresses. This is something you may wish to consider as a part of your birth plan.
The following website is a great resource to read about pain relief options before your birth:
Below is a brief summary of what pain relief options are available to you at Saint Mary’s Hospitals and what you might expect.
| Pain relief options | What is it and what do you do? | How much pain relief and how long does it take to work? | Extra procedures and risks to consider |
| Pool | A birthing pool filled with warm water that you can mobilise in until your baby is born. | A pool may help you to relax as soon as you get in. | Certain conditions may mean that the pool is unsuitable for your labour. |
| TENS
(Transcutaneous electrical nerve stimulation) |
A gentle electrical current which passes through pads on your back, you have a button to press which ‘boosts’ this current during a contraction. | Mild pain relief. Ideal for the early stages of labour. Takes 5 minutes to place pads and set up. | Cannot be used in water or with an epidural. Need to be hired or bought privately. |
| Alternative Therapies | Massage, Hypnobirthing or Supplementary Therapies | Dependant on you. Some skills need to be practiced during pregnancy. | Not offered on the NHS |
| Gas and Air (Entonox) | A mixture of nitrous oxide and oxygen, breathed in by a mouth piece. | Moderate. Starts working immediately, works whilst using it and wears off quickly. | Can make you feel sick and can give you a dry mouth. |
| Pethidine or Diamorphine | An opioid injected into your arm or your leg | Mild to moderate. May help you to relax. 30 minutes until it works fully. Effects last a few hours. | May cause drowsiness in the baby and cause the baby to be slow to breathe. May also slow your breathing down and make you feel dizzy and sick. |
| Remifentanil | An opioid given to you via a drip in your hand. You press a button to give yourself a dose every time you feel a contraction starting. It is designed to be safe and will only allow a dose every 3 minutes | The amount of pain relief varies. You may need to use gas and air as well. 15 minutes to set up and works within a few minutes. In a recent audit, 2/3 women found remifentanil good or very good. | You will need to have a drip put into your hand to administer the medication and have your oxygen levels monitored continuously. You usually need to have a small supply of oxygen given by small soft tubes worn near your nose. You can feel dizzy and sick. Remifentanil can slow down your breathing and your heart rate- you will be closely monitored by your midwife. |
| Epidural | A fine tube threaded into your back by a doctor after numbing the skin. Painkilling medicine is given through this tube which greatly reduces contraction pains. You can control how much extra medicine it gives via a hand held button. You will have to sit in a slight curled-up position whilst the epidural is put in. | You should be pain free or in mild discomfort. One in twenty times the epidural may not work and the anaesthetist may need to replace it or use additional medicine. It usually takes 20 minutes to set up and 20 minutes to start working. If working well it can be ‘topped up’ to keep you pain free for a caesarean section or delivery with a suction cup or forceps. | You will need to have a drip put into your hand to give you fluids as the epidural may cause your blood pressure to drop. Your baby’s heart rate will need to be continuously monitored. You may need a catheter as you will not be able to get out of bed during your labour. There is a small risk of a bad headache or temporary nerve damage such as numbness. Permanent leg weakness is an extremely rare occurrence. |