Pain relief in labor

TENS machine stands for 'transcutaneous electrical nerve stimulation.' They are most effective during the active phase of labor and during the early stages of lower back pain. TENS machines are made up of electrodes that transmit small safe electric currents via a stimulator. As it allows you to be mobile, it is good in the early stages of labor and for home births. TENS machines are not known to be harmful to your baby.

A birthing pool, aromatherapy, and hypnobirthing are other non-medical options with growing popularity that focus on relaxation and mentality to help encourage a positive birthing experience.

Gas and air (also known as Entonox) comprises oxygen and nitrous oxide and is usually the first line in many countries, although not in the US. This is safe and doesn’t cause any harm to the baby. It’s used via a mobile hand-held mask, and the patient is in control of how much they inhale. This doesn’t relieve the pain entirely but helps make the pain a bit more bearable. Gas and air can leave people feeling dizzy and drowsy and occasionally cause symptoms of nausea, vomiting, or dizziness. This is usually limited to the time it’s in use, and once stopped, the symptoms subside quickly.

In the US, an epidural might be considered first-line for most women. Epidurals are given by an anesthetist, and this is where a local anesthetic is injected into the back to provide complete pain relief and numbness to the lower part of your body. A small dose is given at first, and increasing doses can be given later if there is a good response. As this is a local anesthetic procedure, you do not have to be put to sleep. You and the baby will both need to be monitored during labor, and you will no longer be able to walk around.

Side effects include numbness which can last a short time or a long time, a headache, a drop in blood pressure, and difficulty feeling your contractions. This may lead to the labor progressing slowly and requiring help from your medical team, commonly via instrumentation (use of instruments to help deliver your baby).

If a Cesarean section (C-section) is needed, a spinal block is given (unless in rare cases of an emergency C-section where occasionally patients are put to sleep quickly to operate immediately). This is injected in the back to numb the lower part of the body and can last up to 2 hours. This can cause low blood pressure, severe headaches, dizziness, localized itching, and sometimes difficulty initiating lactation.

Opioid injections, such as morphine, are another option. This can help reduce anxiety, can be used in combination with other methods, and can be given at any time during labor. The downside is that it is not always an effective method of pain relief, can cause drowsiness and slowed breathing to both mother and baby, and can negatively affect breastfeeding.