For your first baby, the pain of labor and your reaction to it may be unpredictable. Because of this, it is a good idea to be aware of the available options for pain relief.
Apart from the natural ways of pain relief, such as the TENS technique, water birth, or sterile water injections (SWI), there are three main medical pain relief options — epidural, nitrous oxide and pethidine injections.
This is a special kind of local anesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain.
Although an epidural can provide very good pain relief, it’s not always 100% effective in labor.
One major side effect of epidurals is that they can prolong the second stage of labor, because you may not feel your contractions and won’t know when to help push. Note that your body actually pushes anyway, but it can take longer because you may miss the urge and don’t bear down on it.
If it takes too long, a forceps or a ventouse may be used to help deliver the baby’s head. This is the reason why, sometimes, less anesthetic is given towards the end to let the effect wear off so you can push the baby out naturally. Another side effect is fever for mom which then necessitates full-spectrum antibiotics which can have an effect on the microbiome of the baby at birth.
The only person who can give an epidural is an anesthetist. If you think you need an epidural, check whether your hospital can offer it. The reason a hospital might not offer or recommend an epidural, is a lack of an anesthetist. For the same reason an epidural cannot be performed when giving birth at home.
Nitrous oxide (‘laughing gas)
This is also called ‘laughing gas’. It is mixed with oxygen and delivered to the mother through a tube and a face mask covering her mouth and nose. The gas may take a few seconds to work.
Nitrous oxide may not stop the pain entirely, but it reduces the intensity of each contraction. A lot of women like nitrous oxide because it gives them direct control – you can hold the mask yourself and take deep breaths whenever you need to.
Some possible side effects include nausea, vomiting, confusion and it may not be strong enough for some women.
In some countries, including the United States, this method of pain relief is not very common.
This option involves injecting pethidine into your thigh or buttock. It can reduce pain and make you feel more relaxed. On some occasions, a drug called diamorphine is used.
It usually takes about 20 minutes to work and the effects may last for about two to four hours. The best time to have pethidine is during the first stage of labor — the period before you start pushing.
Don’t take pethidine when Your Child is about to come out, because it can make the little one drowsy, and affect breathing, making it more difficult to get breastfeeding started. Other side effects include feeling woozy, sick, and being forgetful.
In some countries, this method of pain relief is not very common.
Dr. Wanwadee Sapmee Panyakat (OB-GYN) (5 July 2020)