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Medical pain relief
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Everyone manages labour differently and there are many pain relief options available to assist you.
TENS Machine (Transcutaneous Electrical Nerve Stimulation)
- The TENS machine is a small, hand-held unit with wires and self-adhesive pads.
- The pads are placed on 4 points on your back.
- They produce an electrical pulse with a tingling sensation to help block pain sensations during contractions.
- It may help during any phase of labour but work best for back pain.
Where to get a TENS machine
You can hire a TENS through local medical companies and online. They come with operating instructions.
- Launceston
You can hire one through Launceston General Hospital. Call the Maternity Unit on 03 6777 8951. - Hobart
Call the Better Life Company on 6234 5144 or visit them at 83 Brisbane Street Hobart.
Water injections
Injections of small amounts of sterile water into, or just under, the skin of the lower back may relieve some types of labour pain, especially the pain felt in the back. There are no known side effects for mother or baby.
Nitrous oxide (gas)
- Nitrous oxide is a great minimal intervention option.
- This is a mixture of nitrous oxide and oxygen. It is sometimes called ‘laughing gas’.
- It is a very safe option for pain relief in labour.
- You may find the gas helps by taking the ‘edge’ off the pain of the contraction.
- It may also be a good focal point to help slow down breathing during contractions.
- Your midwife will instruct you on how to use it during labour.
- You may experience nausea, light headedness and a dry mouth for a short time.
- There are no after affects for you or your baby.
Narcotic pain relief
- Narcotic medication (morphine or pethidine) are strong pain relievers given by injection.
- They take between 5 to 30 minutes to work depending on the way the drug is given.
- They provide a sedative effect but will not take all the pain away.
- They are given as a single dose injection either under the skin, into a muscle or via intravenous cannula.
- Further doses can be given after around 2 hours.
- This medication does cross the placenta to the baby.
- It can make you and your baby sleepy.
- This may reduce respiratory effort in your baby if given close to birth.
- Morphine is more rapidly eliminated than pethidine so the effects to baby may resolve quicker.
Epidural anaesthesia
- Epidural anaesthesia is an effective means of pain relief.
- This is the only pain relief that has the ability to take the pain of labour away almost completely.
- You will always have an intravenous infusion inserted, a monitoring machine to measure baby’s heart rate and to measure your contractions. A urinary bladder catheter is always needed.
- Only a specialist doctor called an anaesthetist can give an epidural anaesthetic.
- You will be given a local anaesthetic into the skin of your back before the epidural is inserted.
- After this you should only feel a dull pushing sensation on your back.
- A thin flexible plastic catheter is inserted into the epidural space of your spinal cord.
- This will stay taped in place until after the birth when it will be removed.
- Anaesthetic drugs are given continuously through the labour, pushing and any suturing (wound stitching).
- You can have Patient Controlled Epidural Analgesia for smaller continual doses as needed.
- If you have an epidural for pain relief in labour, it will be turned off after suturing (post placenta delivery).
- Generally, it takes 1-2 hours to feel full sensation and strength in your legs again.
- When standing for the first time after the epidural is removed, have a staff member with you to prevent falls.
Advantages of epidural anaesthesia
- It can allow you to rest during a long or painful labour.
- It is the only form of pain relief that causes little or no drowsiness to you or your baby.
- If a forceps or caesarean birth or other procedure is needed, a stronger epidural may be used.
- An epidural does not necessarily lead to an increased risk of a caesarean birth.
- There is a slightly higher chance of a ventouse or forceps birth as the urge to push may not be felt.
- Anaesthetic and pain-relieving procedures are typically reliable and safe but do have some risks.
- Despite the high standards of medical practice, complications can occur.
Possible complications of epidural anaesthesia
- Your blood pressure may fall, and this may affect your baby.
- To prevent this, an intravenous drip line is inserted beforehand so fluid and medications can be given quickly.
- Walking around is not possible due to heaviness and numbness in the legs but you can usually move freely in the bed.
- Irregular or ineffective pain relief can sometimes occur if the anaesthetic agent does not spread evenly. A top-up, re-positioning or replacement of the epidural may occur.
- A leak of spinal fluid can cause a severe headache. Some leaks heal on their own. Others may require a further epidural injection.
- Local tenderness and bruising can occur around the site of the epidural. This usually resolves within 7-10 days.
- Shivering, nausea and vomiting may occur. This frequently occurs in a normal labour too.
- Intense itching with some types of medication can sometimes occur.
- Rarely, an allergic reaction to an anaesthetic agent may occur.
- Occasionally, the anaesthetic service is unavailable or delayed.
Rare complications of epidural anaesthesia
- The epidural site may become infected. You will require antibiotics.
- Very rarely this may lead to meningitis or an epidural abscess.
- The local anaesthetic may be accidentally injected into a blood vessel. This can cause dizziness, a metallic taste in the mouth, and in extreme cases, convulsions and significant heart problems.
- Temporary damage to spinal nerves outside the spinal column may occur. Virtually all of these cases recover within a few weeks or months.
- Permanent but rare damage may occur ranging from nerve damage to paralysis.
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