Pain and, just as stressful, the fear of pain, is one of the major areas of concern about labor and delivery, especially for first-time mums and their partners. It is also an area full of myth and misinformation. Knowledge helps dispel the fear and reduce anxiety levels, so talking with your doctor or midwife is important.

The role of pain management is to make the labor and delivery as safe and relaxed as possible, for both the mother and the baby, and to create a positive and rewarding experience.

The choice of pain management methods is very personal and should be guided by a healthcare expert to ensure that the pain management used is not only adequate but also appropriate to the wishes of the mother. There are several pain management options widely available to mothers and they can provide a lot of help and reassurance.

A mother should know about the different forms of pain relief early in her pregnancy. It must be remembered that tolerance to pain varies from one person to another. Mothers also have different attitudes to pain – some want to feel everything, some want to feel nothing and others fall somewhere in between. Some mothers may also have firm views on the use of drugs which may affect the baby. For example, Pethidine can affect the baby’s breathing, whilst nitrous oxide has less effect.

However, there are many techniques that can help with the first pains of contractions – a hot bath or shower, relaxation and massage, use of a birthing ball or TENS machine and movements from walking to just changing positions, can all help. Perhaps the most important element is a calm, relaxed support person to help mum remember her breathing techniques, help manage the pain.

Once the pain relief is no longer adequate, then it is time to come to the hospital and, on arrival, the midwife will perform an assessment. The condition of the mother, the stage of labor and the dilation achieved, will all influence what pain management may be appropriate. Nitrous oxide (gas and air) and pethidine may both be options.

When other forms of pain relief prove insufficient for the patients needs, an epidural may be used. This is an injection of a local anesthetic in the small of the back and the insertion of a fine catheter through which pain killer medication can be given and adjusted according to need and to control the level of pain.

Epidurals are sometimes specifically recommended by obstetricains to help patients with medical or obstetric problems, such as premature babies, twin pregnancy, high blood pressure etc..

Minimal amounts of pain killer medication reach the baby, so the baby is not sedated and there are no noticeable effects when administered by an anesthetist (and managed by a skilled midwife).

Pain is a natural part of childbirth and should not be feared but accepted. Understanding the pain and adopting an open mind to managing it is the key to a successful, safe and rewarding birth. The good news is that pain can be managed and that with every baby delivered by a mother, the birth becomes much easier and pain management less of a concern.