Pain relief during childbirth

The more prepared for childbirth and convinced of your pregnant body’s ability to give birth you are, the easier it will be to manage labour and contractions. For partners, it’s especially good to know the options and be able to speak for the person giving birth – who will be busy managing the next contraction. Pain relief is an entire science, and even if you aren’t a total expert – a midwife will be present who has loads of expertise, of course – it can still be good to understand the basics. Pain relief is generally split into two categories: natural, non-medical pain relief for childbirth, and medical options.

Natural and non-medical pain relief

In the presence of enormous stressors, such as childbirth, the body produces endorphins as a way to manage pain. Known as the body’s morphine, thanks to the pain-relieving effect, endorphins also subdue stress, enhance a sense of well-being, and don’t affect the baby or course of events during childbirth. This makes endorphins the body’s own natural form of pain relief – and we’ve listed the most common ways to get a boost.

• Water for injection. A small amount of sterile water is injected under the skin where you have pain, through a thin needle. The effects last up to an hour and a half, but the procedure can be repeated if needed.
• TENS: transcutaneous electrical nerve stimulation. This small device generates gentle vibrations to stimulate the nerves in the back through two to four electrodes. This can eliminate pain peaks and alleviate the intensity of contractions.
• Massage. Giving a lower back massage is the perfect job for a partner, if one is present. Massage releases oxytocin, which in addition to helping you relax, also stimulates contractions and makes them more effective. Massage, whether strokes or the application of pressure, can provide relief throughout the entirety of childbirth.
• Acupuncture. Some midwives can offer acupuncture during childbirth; you can always ask if this is something you want to try. Inserting needles into special acupuncture points boosts the release of certain substances, like endorphins.
• Heat. A hot wheat pillow or hot water bottle can offer significant relief and help you relax, both during the early opening phase and active phase of childbirth.
• Hot water. Standing or sitting in a hot shower or weightlessly floating in a tub can alleviate pain and help your body relax.

You can always change your mind!

Despite the fact that many people want to give birth without pain relief, medical pain relief is still the most common. It is common to be overwhelmed by the pain of contractions, so it’s important to remember that just because you can give birth without pain relief doesn’t mean you have to. It’s also good to be prepared for the fact that childbirth is unpredictable and you have permission to change your mind. The midwife can give you advice and explain the pros and cons, but the best approach is to have a sense before you go into labour.

Medical pain relief

Medical pain relief refers to various anaesthetics that are given in the form of drugs.

• Laughing gas (nitrous oxide). This chemical compound of oxygen and nitrogen acts as an analgesic that relaxes you and provides a temporary feeling of intoxication when inhaled. You get to be in control of the strength of the gas; it’s up to you how strong it is and how much you want to inhale. It does not affect the baby and exits the body as fast as it comes in.
• Morphine. Taken as a tablet or injection in the skin or a vein, depending on how quickly you want relief. It removes pain peaks during contractions and helps you relax. Because morphine passes through the placenta, it is mainly used early on during labour, to give the mother a chance to sleep and gather strength, especially if the latent phase is taking a particularly long time. Morphine shouldn’t be used too close to the actual birth, because there is a risk that the baby could become drowsy and struggle to start breathing properly.
• Epidural. Anaesthetic injected in the lower spine that can alleviate pain, allowing for nearly pain-free contractions. The effect usually wears off after a few hours, as the intensity of the contractions increases. The epidural is one of the most common forms of pain relief. It does not pass through the placenta, so it does not directly affect the baby. But continuous CTG monitoring will still be carried out to make sure the baby is doing well.
• Spinal anaesthesia. This is another form of anaesthesia that numbs you from the chest all the way to the thighs. Spinal anaesthesia can be given when it seems that the labour will be fairly quick, for example if this is not your first baby. Is also used for C-sections, but in a higher dose that numbs all the way down to the toes. As with an epidural, continuous CTG monitoring is carried out to make sure the baby is doing well.
• Pudendal block (pelvic anaesthesia). A fairly uncommon form of anaesthesia these days, it is given by injecting an anaesthetic high into the vaginal opening. It numbs the nerves and minimises pain as the baby is pushed out. A drawback is that anaesthesia can prolong the pushing phase and make it difficult for the mother to feel exactly what to do. However, it is an excellent form of pain relief after childbirth if the midwife or doctor needs to sew up vaginal or perineal tearing.
• General anaesthesia. Under general anaesthesia, you are asleep. This is used for emergency C-sections when there is no time for spinal anaesthesia, or when a vacuum extraction is not appropriate.
• Paracervical block (anaesthesia of the cervix). Anaesthetic injected at four locations at the cervix. It makes contractions less painful and is often given to non-first-timers, because the effect only lasts for about two hours. However, it can be given a second time.

Please note that all information above is based on Swedish recommendations.