Transcutaneous Electrical Nerve Stimulation
What is it: More commonly known as a TENS device, this small machine with electrode pads uses electrical impulses to inhibit the pain arising from the womb and cervix. It works well for some people, but is usually only effective in the early stages of labour, and other pain-relieving methods might be needed in the later stages.
Gas and air
What is it: Entonox is a premix of 50 per cent oxygen and nitrous oxide (laughing gas). While it can be effective, it doesn’t give steady relief as while the contractions are happening, mums tend to inhale greater quantities, resulting in an overdose, and can even stop breathing at times. Thus, a steady, pain-free period is never attained.
Pain relief injections
What is it: Opioids (pethidine, morphine, diamorphine, fentanyl, remifentanil) administered either intravenously or via injections are effective at reducing pain. However, they are narcotic depressant drugs and can cross the placenta to the baby, potentially producing drowsiness and depression of respiration in the newborn.
What is it: Epidural analgesia is the most effective and flexible technique available for control of labour pain. A catheter is positioned into the spinal column and a derivative of morphine and low concentration local anaesthetic drug is injected to the epidural space of the spinal column at a pre-calculated rate, using a device known as syringe pump. This can be controlled according to the pain threshold of the patient, with amounts lessened as labour progresses to the pushing stage, so that mum has enough sensation to actively take part in the delivery.
What is it: Commonly used in planned caesareans, a spinal block is different to an epidural. Scientifically called a ‘subarachnoid block’, the drug is injected to a space beneath the arachnoid (which is a covering of the spinal cord) which contains a fluid known as cerebrospinal fluid (CSF). It’s a one-injection shot, and usually lasts for around two to three hours, allowing the operation to be carried out pain-free, while mum remains fully awake.