There are many ways of reducing the level of pain and discomfort during labour without the use of medication.

Instinctively a woman in labour wants to adopt upright and mobile positions, as she is more comfortable like this.

The benefits are:

• walking around keeps you more comfortable and avoids backache
• remaining upright helps your labour progress more efficiently and makes it shorter; the natural effects of gravity are maximised
• remaining upright allows for maximum space to be achieved in the pelvis, so your baby’s passage is easier
• remaining upright allows for maximum oxygen to reach your baby during labour and birth.

Breathing techniques can act as a diversion from the intensity of your contractions.

The techniques are ideally used in conjunction with relaxation techniques as the first line in pain relief.

You can learn these specialised breathing and relaxation techniques at our antenatal classes.

Massage is very comforting for women in labour and is most effective when performed by your birth partner(s).

Practice makes perfect and you can learn labour massage techniques at your antenatal classes.

Using self hypnosis in labour is increasingly popular. Women who decide to use hypnosis to help them cope in labour usually start practicing during the pregnancy. The Portland Hospital offers hypnobirthing classes with our specially trained midwives.

TENS should be commenced at home at the beginning of labour for it to be most effective, as the effect is accumulative. It works by sending gentle electrical currents from a small battery powered device through four flat plasters placed on your back.

This creates a tingling feeling which you can control the strength of, and boost during a contraction. It has no harmful effects on either you or your baby. TENS works by helping to release your body’s own painkillers (endorphins) and the effect increases the longer you use it. 

TENS units should be hired or purchased before going into labour. More information is available from the booking clinic midwives and at our antenatal classes.

The Portland Hospital offers the opportunity to labour and/or birth in our specially designed birthing pool. The warm sensations of the water on your skin will help you cope better during contractions.

The buoyancy of the water helps you maintain upright yet relaxed positions and you generally labour faster in the pool as a result. This helps enormously to make you more comfortable in upright positions. The relaxing effect of the water stimulates your body to produce endorphins, or your body’s own natural painkiller.

The following forms of pain relief involve the use of medication.

Entonox

Entonox is a gas made up of 50 per cent nitrous oxide and 50 per cent oxygen which is known as gas and air. You breathe this through a mask or mouthpiece and it can be used at any time during labour. It is simple and quick to act, and wears off once you stop using Entonox, usually within minutes.

It does not harm your baby and it gives you extra oxygen, which can be good for you and your baby. You control the amount of Entonox you use, but to get the best effect, timing is important.

You should start breathing Entonox as soon as you feel a contraction coming on, so you get the full effect when the contraction is at its peak.
In line with standard midwifery practice at The Portland Hospital, Entonox can be offered as a pain relief option while using the pool. Your midwife will be able to discuss this with you further.

You can also combine Entonox with a TENS unit for even more effective pain relief.

Epidural analgesia

The most effective form of pain relief in labour is an epidural. This is a form of pain local anaesthetic, the nerves to the womb and birth canal are numbed by giving an injection in the lower back.

Having an epidural may have an effect on your progress in labour. At The Portland Hospital we offer mobile epidurals. This can provide excellent pain relief while allowing you to keep some feeling in your legs. This means you may be able to move around in labour. Before you can get out of bed and walk with your epidural in place, the midwife will need to ensure that you have enough feeling and strength in your legs.

Once the epidural is inserted you will be asked not to eat, but you may continue to drink clear fluids.

Pain relieving injections

This form of pain relief is most suited for women having their first baby or a longer labour. These are known as opioids and include painkillers such as Diamorphine, Pethidine and Morphine. These start taking effect after about half an hour and last up to four hours. Some women say that this type of medication makes them feel more relaxed and it is possible to fall asleep for brief periods.

These pain medications are known to cause side effects. Therefore the doses used are small. They may make you feel sick, but you are usually given an anti-sickness medication to prevent this. They may make your baby a bit sleepy and occasionally slow to feed.