Pain Relief

Please click on the dropdown tabs for details of medical and non-medical pain relief. To familiarise yourself with our anaesthetists please click here.

For further resources and patient information on pain relief in labour, please visit www.labourpains.org or NHS Pain relief in labour.

Medical pain relief

Dihydrocodeine
A narcotic that blocks pain signals being sent to your brain. It is given in the form of 1x 30mg tablet, every 4-6 hours. It takes 15-20 minutes to work and lasts for 2-4 hours.
Pros	Cons
This drug can be taken at home	Prolonged use can cause constipation
	Not very strong
	Crosses the placenta

Entonox ('gas and air')
A mixture of nitrous oxide and oxygen. You breathe in the gas and air via a mouthpiece. The gas takes about 10-15 seconds to work and 10-15 seconds to leave the body.
Pros	Cons
Doesn’t affect the baby	Only works well if properly timed with contractions
You can still mobilise	It can make you feel lightheaded or sick
You can still opt to use additional pain relief

Pethidine or Diamorphine
It is given via injection into muscle, every 4-6 hours and takes 20 minutes to dull your central nervous system, so not as many signals of pain are detected. Often combined with an anti-sickness.
Pros	Cons
Allows for rest during labour	Can cause respiratory distress for both mum and baby
	Baby can stay drowsy initially after birth, which can affect breastfeeding
	Can’t be used with water births
	Often causes sickness

Epidural
A local anaesthetic that blocks the nerves that carry the signals of pain to your brain. It is administered by an anaesthetist, who puts a needle in your back initially, and then a small tube is left in place. It takes 20 minutes to work after insertion but works until the tube is removed after your baby is born.
Pros	Cons
It is the most effective method of pain relief	You will require a urinary catheter as an epidural causes a loss of sensation from the bladder
Allows for rest during labour	You will require a cannula in your vein
It does not cause drowsiness	An epidural may reduce the urge to push and so prolong the second stage of labour
Helps to decrease the normal stress response to the pain and effort of labour, including raised blood pressure and heart rate, therefore may be beneficial to those with certain medical conditions such as pre-eclampsia.	It can limit your mobility, as it may make your legs temporarily weak or numb
	Baby will require continuous foetal monitoring

Remifentanyl
A powerful morphine-type drug used regularly in anaesthetics. It is administered via a drip in your hand, which works after 5 minutes of being inserted, and then via a button that you can press to provide pain relief on demand.
Pros	Cons
You can still mobilise	Can cause respiratory distress for mum and baby
No need for a urinary catheter	Can cause sickness and dizziness for mum
You can still opt to have an epidural later

Non-Medical pain relief

Transcutaneous-Electronic Nerve Stimulation (TENS) machine
A handheld battery-powered device which sends a gentle electrical current though four sticky gel pads that are placed on to your lower back. The pads create a tingling sensation, which stimulate your body to make endorphins (natural pain relief).
Pros	Cons
You can control the intensity yourself	Can’t be used with water births
The device can be used at home	Can’t be used with epidural
No side effects for you or the baby
Portable, you can still mobilise
You can still opt to use additional pain relief

Aromatherapy
Within Salisbury Maternity Unit there are a number of midwives who are trained in the administration of aromatherapy to women in labour. The midwife caring for you will be able to answer any questions or concerns about aromatherapy, as well as discussing the blend of essential oils that is right for you at your stage of labour. Aromatherapy involves the use of essential oils to enhance physical and mental wellbeing. Essential oils consist of thousands of chemical constituents, each different essential oil and its constituents having an effect on different systems in the body. There are several methods in which you can benefit from these essential oils. They can either be used directly on the body (for example diluted in a carrier oil in the form of massage or on a compress) or inhaled.
Pros	Cons
No side effects for you or the baby	Not very strong
Encourages relaxation & relieves stress/anxiety
Can be used alongside other forms of pain relief
Can help manage nausea, vomiting and help encourage uterine contractions

Water
If you find a bath is helpful for period pain/back ache, then you may find a bath or shower will ease some discomfort in the early stages of labour. Some women find it such excellent pain relief that they choose to birth in water, however this may not be advised for all women. Your community midwife will be able to advise as to where you can hire a birthing pool from, for a home birth.
Pros	Cons
No side effects for you or the baby	Can’t be used with a TENS machine
Can still opt to use additional pain relief if needed	Can’t be used with diamorphine

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