What is it? How is it used?

It's popular drug-free option for managing labour pain. A small machine sends gentle electrical pulses through pads stuck onto your back, which can help block pain messages and prompt your body to release endorphins, its own natural painkillers. You can turn the intensity up and down as needed. TENS works best when started in early labour, and many women use it at home before heading to the maternity unit.

Pros: 

• Drug-free, with no known side effects for you or your baby
• Can help with backache during labour
• You are in control, increasing the intensity as contractions get stronger
• You can stay upright and keep moving
• Can be combined with other forms of pain relief

Cons:

• As labour progresses, you may need more pain relief than TENS can provide
• It doesn’t work for everyone, or for every labour, though many women find it helpful
• It can’t be used in the bath, shower or birth pool
• You’ll need to organise one before labour starts

How to get one: 

Ask your LMC, as they may have one you can borrow. Otherwise, you can hire one online (prices usually start from around $70) or buy your own.

What is it? How is it used?

Opioids such as Morphine & Fentanyl can be given intravenously (via a drip) as well as into the muscle (IM) - thigh or bottom. Pethidine can be given IM. Opioids can take up to 20 minutes to be effective and lasts for two to four hours. They do not fully block out pain or feeling. 

Pros:

• May enable you to rest if labour is long and difficult
• Some women find opioids help ‘distance’ them from the pain
• If you are feeling anxious, it may relax you and help contractions be more effective

Cons:

• May make you feel dizzy or sick but an antiemetic (anti-sickness) medication is usually given at the same time to combat this
• You may dislike feeling ‘detached’ from what’s happening
• Pethidine has a long half life and may make your baby disorganised with breastfeeding and/or sleepy for a few days

What is it? How is it used?

Remifentanil is an opioid that is generally administered via patient controlled analgesia (PCA). It works quickly and wears off quickly. Within 10 minutes of PCA dose being administered the drug will have been metabolised by both parent and baby.

Pros:

Along with Morphine, Fentanyl & Pethidine when Remifentanil is given via a PCA pump you have the ability to manage your own pain relief without concerns of overdose.

Cons:

Like Pethidine, Remifentanil may make baby sleepy and disorganised with breastfeeding once delivered however unlike Pethidine the half life is very short so these tend to resolve within minutes.

What is it? How is it used?

• You breathe gas in through a mouth-piece or mask
• Take several good deep breaths at the very beginning of each contraction
• You hold the mask or mouthpiece and take as much or as little as you need

Pros:

• You are in control
• The gas doesn’t linger in your system
• Only affects alertness temporarily as it’s quickly breathed in and out

Cons:

• It’s only a mild form of pain relief
• May make you feel slightly sick
• You may not like the feeling of light-headedness it gives

What is it? How is it used?

This injection into your lower back numbs your body so you don’t feel the contractions. It takes 20 minutes to set up and another 5 to 20 minutes for the anaesthetic to work.

Pros:

• It can mean you feel little to no pain during labour
• Most effective form of pain relief in labour
• In some centres in Aotearoa you might have a low dose epidural, which means you can move more freely around the bed or room. Regardless of the type of epidural you have, you’re not more likely to need a caesarean birth or forceps/ventouse for baby to be born

Cons:

• You might have a catheter if you’re unable to tell when your bladder is full
• May have an area that is unable to be numbed causing a patchy effect
• Can increase the length of the labour by on average 12-15 minutes
• May cause sudden fall in blood pressure and may cause headache after delivery
• Some women find they may have mild back ache (bruised feeling) where the epidural was inserted

Check out our Epidural page for further info including a step-by-step.

Water/heat packs/hot water bottles

Some women find that using warm water during the early phases of labour helps ease the pain. Heatpacks or taking a shower/bath may also help with back pain. If your baby is in a posterior position (baby’s spine to your spine) you may have strong back pain. Heat can significantly help reduce this.

Massage

Having someone massage or firmly pressing on your lower back and shoulders can help to relieve some of the discomfort during contractions.

Breathing

Slow deep breathing maximises the amount of oxygen available to you and your baby and can calm both of you as well. Focusing on your breathing may help you to get through each contraction by distraction.

Acupressure

Acupressure works by pressing on certain pressure points within your body. During labour this can provide relief by activating acupoints which helps to reduce muscle tension and promote blood circulation.

Hypnobirthing

Hypnobirthing uses a mixture of self-hypnosis, relaxation and breathing techniques to overcome pain in labour. It encourages you to achieve a measure of relaxation during their labour.

Aromatherapy

Oils such as Clary Sage, Jasmine, Frankincense and Lavender are often used during labour. Clary Sage helps with cramping aching of muscles during labour and can help ease feelings of panic and anxiety. Jasmine can help to relieve pain during the early phases of labour and can help to strengthen contractions. Frankincense can ease labour discomfort by rubbing on lower back and abdomen. Discuss with a qualified aromatherapist which oils may work best for your birth. Remember the use of essential oils must be done with caution.