Pain Relief in Labour

Drug Free

Breathing Techniques and Relaxation

This can be used by everyone, whether or not other methods are used. Breathing techniques help to keep you relaxed which helps relieve tension. The less tense you are the less things hurt, as you may know from having injections/blood tests etc. Breathing techniques and relaxation are normally taught at antenatal classes, but the general idea is to breathe slowly and steadily, focusing on the out breath. It often helps if your birth partner does the slow breathing too, as this will help remind you what to do (just saying "breathe" won't help much, as I experienced!). Relaxing music in the background can also help, along with visualisation of peaceful scenes.

Water

In my personal opinion water is a very useful aid for ME/CFS sufferers during labour. Labouring in water reduces pain, aids relaxation and, especially useful for ME/CFS sufferers, it supports some of your body weight, making it easier to find and maintain comfortable positions.

I wanted to use a birthing pool during my first labour but was fobbed off by the hospital staff (apparently this happens fairly often). For my second birth I was at home and bought a birthing pool, the relief was almost immediate when I got in and I certainly noticed that contractions were more painful when i needed to get out to use the toilet.

You shouldn't get into a birthing pool until you are at least 5cm dilated else labour can slow down, but can stay there to birth if you chose. You can use gas and air while in the pool, but not pethidine, epidural or TENS.

TENS ( Transcutaneous Electrical Nerve Stimulation)

A TENS machine uses electrical pulses via pads on your back which create endorphins (feel-good hormones), these block the pain messages from your womb. You can control the level that it is set to. You can also use other pain relieving drugs such as pethidine or gas and air while using TENS.


Drugs

Drugs tend in general to provide more effective pain relief, but you may find your body reacts unusually to them, and some can affect the baby.

Entonox (gas and air)

This is a mild pain killer that's a gas mixture of 50% oxygen and 50% nitrous oxide, it is pumped directly into equipment on hospital labour wards, or held in canisters for home births. You can use it when you need it in labour, breathing it in deeply and evenly during contractions via a mouthpiece or mask. It doesn't remain in the body for long, the advantage of this is that if you find it gives you side affects (common ones being nausea and lightheadedness) you can stop using it and the side affect will quickly diminish. However it does mean that you have to keep using it to get the pain relief, I found it only helped with the pain when I was inhaling it, and that it only takes the edge of the pain rather than completely removing it.

It does cross the placenta, but is not thought to have any affect on the baby.

Epidurals

Epidural's are local anaesthetic which is administered by an anaesthetist into the area around the spinal cord, it blocks all pain below the site of the injection. It takes about 20 minutes for the procedure to take place and the effects last about 2 hours (but can be topped up via a drip). Most women get total pain relief with an epidural which makes it very useful for ME/CFS sufferers, espeically during long labours, as you can rest and even sleep for a while to save your energy for the final push.

However epidural's tend to make the labour longer, and there is a slightly higher chance that you will have an oxytocin injection (to speed up contractions) or need forceps, ventouse or cesarean section. Some people also find that they have longer term problems like headaches or backache after having an epidural.

One member of this group reports that her anaesthetist had trouble inserting the epidural, which the anaesthetist believed was due to weakening of the muscles in the back due to ME.

Pethidine

Pethidine is injected into the muscle of the buttock or thigh. It is a similar drug to morphine and takes about 20 minutes to start working and lasts about 2 to 3 hours. People describe it as helping them distance themselves from the pain, or sending them to sleep. Some women find it doesn't offer them any pain relief, and others hate the drug, saying they lost any sense of control. It offers better pain relief in early labour than later labour.

It can cause nausea so you are likely to be given an anti-sickness drug too. It crosses the placenta and is present in breastmilk, can cause breathing problems if the baby is born between 1 and 3 hours after the injection is given and can cause the baby to be sleepy and affect its sucking reflex for a few days after birth. Meptid is a less available alternative to Pethidine that has less likely hood of causing problems in the baby.

You can get different size doses, 50mg, 100mg or 150mg, if you do decide to try pethidine I would recommend trying the lowest dose if you know you are sensitive to drugs, you can always have another dose if you need it. But I would not recommend the use of this to ME/CFS sufferers.