Pain relief at the birth: the options

We've all seen women in labour. They're there in soap operas, movies and documentaries, normally screaming and blaming their partners. Don't worry, it really isn't that bad, and there is a wide range of pain relief options available to your partner. Dad Info compares the options...

The fact that labour pain is natural and inevitable doesn't mean that your partner has to put up with it and it's certainly possible to have, if not a pain free labour, at least a short respite.

• While some women prefer to go with a natural birth, using natural pain relieving methods such as siting in water and massage (which you can do).
  
• Others opt for pain relief, whether in the form of an epidural, pethidine, gas and oxygen (Entonox), or TENS - or a combination of methods. Pain medication may affect the baby and the progress of the labour though.
  
• You should discuss your partner's expectations well in advance of the big day to be sure that you understand what she wants.
• Birth plan: what's that all about?

Your role

Pain relief: you
The best thing you can do is help her keep calm and relaxed - this will help her release her own natural-pain killers.

Just being there and giving her your support makes a world of difference; whether that’s holding her hand or communicating the birth plan when she can’t talk for gritted teeth.

• If you are asked about something make sure you stick to her wishes and follow the plan. If she has chosen a natural birth, don’t rush her into an epidural at the first moan or cry.
• Research shows that women whose partners are there supporting them during the delivery feel less pain, end up taking less medication and feel more positive about birth experiences than women whose partners don't participate.
• If you can help to relax her and take her mind off what’s going on you can help her to cope with the pain. The calmer and more relaxed you are, the more helpful you'll be.
• Being at the birth: the pros and cons
• The birth: a midwife writes

Here are the options:

Epidural

Epidural is the most popular form of pain relief in the UK.

An anaesthetist injects a local anaesthetic mixed with narcotics into the back of the spine through a tiny plastic tube which can be connected to a pump - or the doctor can give periodic injections.

It is also possible to have a lower dose walking epidural

Pros:

• Blocks most pain in the abdomen (although she will still feel the pressure) within about ten minutes
• Very useful if an emergency Caesarean is needed (in which case a spinal epidural may be used, causing profound numbness and pain relief)

Cons:

• Requires constant monitoring
• Can slow labour, lower blood pressure and cause headaches
• Makes a Caesarean more likely because it is harder to push
• Can take away all feeling, making it hard to pee (a catheter is then inserted into the bladder)
• There is a higher incidence of long-term back pain related to epidurals

Entonox

• A mixture of laughing gas (nitrous oxide) and oxygen taken through a mask or mouthpiece. Gas can also be used for a general anaesthetic before an emergency Caesarean

Pros:

• Reduces pain and helps to calm and relax your partner
• Does not restrict movement

Cons:

• Can cause nausea or make your partner feel spaced out
• Doesn’t always work

TENS

Wires inside pads attached to the back send electrical currents to block pain messages to the brain.

Pros:

• Does not affect the baby
• Your partner can remain in control by varying levels (she holds the TENS unit) and she can move around
• Particularly good for back ache

Cons:

• Some women find it irritating
• If used late in labour, it may be ineffective
• Does not remove the pain, but may make it easier to manage
  

Pethidine

A drug which has a similar feeling to morphine, given either through injection in the buttocks or thigh. Still commonly used but less so than in the past. It is an opioid, which mimics the natural endorphins. Tranquilisers can also be given (usually with a narcotic).

Pros:

• Takes the edge off the pain, particularly when early labour is prolonged

Cons:

• Hinders ability to walk around because she may be unsteady on her feet
• Can cause nausea
• Makes her drowsy
• Is likely to make the baby sleepy and less interested in feeding for a couple of days
• If given too close to the birth, the baby may be slow to breathe and need an antidote
  

A natural birth

• With a natural birth the pain is managed through breathing exercises, massage, relaxation techniques and warm baths
• Your partner is not hooked up to any medical equipment and is able to move about
• Getting her into warm water can help – particularly for relaxation, making the contractions easier to bear

But even the best laid birth plans can be binned on the big day, especially if labour is prolonged or there are complications. If the delivery has complications pain relief may be essential.

Author

Gavin Evans is a father of two daughters - aged 17 and 13 - and lives in North London. 15 years ago he changed gear from being a full-time reporter to full-time parent and part-time journalist. His writing on issues affecting fathers has been published in a wide range of publications including The Guardian, The Independent, Men's Health, Cosmopolitan, The Times and The New Statesman. He has written five books on sport, a chapter on men in Your Pregnancy Bible and is completing his first screenplay. Gavin also regularly posts blogs at www.gavinevans.net.

Your experiences  

Got any wisdom about pain relief you'd like to share with other dads? What worked best for your partner? Use the comments system below to share your experiences.