Coping in labour

Whether at home or in hospital these tips may be useful for you:

• Low fat foods are recommended to avoid nausea and sickness (your partner may bring in some food for you)—we have hospital restaurants, coffee bars, shops and cold drinks machines at each site and, if you are at Chelsea, there are restaurants on Fulham Road
• Flannel, sponge and water spray may be useful for cooling off
• Lip salve, toiletries and hair accessories keep your hair out of your face
• Oil for massage, as this can be very relaxing and help with pain relief such as backache (although not all women will find it helpful)—please discuss with your midwife
• Old shirts or t-shirts to wear for labour and warm socks

Pain relief in labour

There are many ways of helping to relieve pain and discomfort during labour. These can range from simple things such as relaxing in water, walking about and TENS machines to entonox (gas and air), pethidine and epidurals. You will be given a separate leaflet on pain relief. All women are different and one method of pain relief may work well for some and not for others. It is best to keep an open mind and, if something is not working well, try something else.

Please discuss the different kinds of pain relief available with your midwife, doctor or the anaesthetist. It will also be discussed in antenatal classes.

TENS

TENS (or transcutaneous electrical nerve stimulation) works by attaching four pads to your back through which continuous electrical impulses are sent. This blocks pain signals to your brain and also stimulates your body to produce endorphins.

TENS is entirely safe as the pads are attached by wires to a small battery-operated control box which hooks on to your clothes.

The facts

• There is no evidence of risk to mother or baby
• TENS is most useful in early labour and lets you move around freely
• TENS is less effective during active labour
• You can control the rate and strength of the electrical impulses
• TENS can be used in combination with other methods of pain relief (but not in water)
   
• Read more about TENS and how it works

Please note: The maternity unit does not supply TENS machines, so you will have to hire or purchase one yourself and bring it with you if you would like to use this method of pain relief.

Hydrotherapy

Hydrotherapy is the name given to the use of water in the treatment of different conditions. It is used to give pain relief for a variety of ailments including arthritis and rheumatism—but is also often used during labour.

The facts

• In early labour at home, a warm bath or shower can be very relaxing and support mobility
• We have birthing pools for women who wish to continue their labour and/or give birth in water—the water is kept at a comfortable temperature just below 37.5°C

The National Childbirth Trust has lots of information on using water during pregnancy and birth.

Paracetamol and co-codamol

Paracetamol

Paracetamol belongs to group of medicines known as 'analgesics' or 'painkillers'. It is used to relieve mild to moderate pain and is also helpful in lowering a raised temperature or fever.

Paracetamol can safely be used in early labour and during postnatal care. It is a common painkiller and available from all pharmacies, in tablets, capsules and liquid form, without the need for a prescription.

Co-codamol

Co-codamol contains two painkilling ingredients – paracetamol and codeine. It is usually taken in tablet form to relieve short-term pain where paracetamol alone is not sufficient.

Co-codamol can safely be used in early labour and during postnatal care. It is also available from pharmacies without the need for a prescription.

• Read more about paracetamol and co-codamol

Entonox

Entonox—often referred to as 'gas and air’—provides pain relief when inhaled and is often used by women to ease their labour. It's a combination of nitrous oxide gas and oxygen, which is breathed in and out through a mouthpiece during contractions when in established labour to relieve pain. Your midwife will provide clear instructions on correct use of equipment being used, including exhaling into the rebreather mask or out through the mouthpiece.

The facts

• There is no evidence of risk to mother or baby
• Can be used in combination with any other method of pain relief
• Effects are rapid and wear off quickly
• You control how much you want to use and when
• It can be used as a pain relief method for home births
• It can make some women feel light-headed and sick
• Prolonged use can make you tired and thirsty, so you need to drink plenty of fluids

Acupuncture, reflexology and homeopathy

If you wish to arrange your own complementary therapies, please ask your midwife for advice.

If you would like your own practitioner to come in with you when you are in labour, they will require an honorary contract and will need to contact the Head of Midwifery Services to arrange this.

Pethidine and meptid

Pethidine and meptid are both pain relieving drugs that are administered by injection into the thigh or buttock. They take about 20 minutes to work and the effects last for 2 to 4 hours.

The facts

• Pethidine is recommended in cases where mothers are very tired or anxious, as it can make you feel sleepy and relaxed (whereas with Meptid you generally feel more alert)
• They can make some women feel nauseous and a further drug is then given to combat sickness and vomiting
• You cannot use a deep bath or birthing pool after taking pethidine or Meptid until the effects have worn off
• Pethidine crosses the placental barrier in labour—meaning it can remain in the baby's system for up to 72 hours—this is not dangerous but may interfere with the first feed if given to the mother close to the birth