Pain medication

You can never predict the course of your delivery which makes it an exciting yet sometimes scary event. It is unpredictable how your body will react to contractions and labour. To maintain in control of your delivery it is important to be aware of the options available to lighten your pain.

Zie ook de volledige KNOV folder over pijn.

Light and comfort enhancing methods

Every woman experiences pain when in labour and it differs per person which position is most comfortable. It is mostly a case of trying what suits you most. This folder contains a few examples of positions to try during labour.

See KNOV folder about positions

During labour you can experience pain in your lower back or legs because the baby causes pressure on your hip joints. It may help if your partner or we massage the sore places so there is some counter pressure.

Warmth will improve the relaxation necessary to produce endorphin, the hormone that works as a natural painkiller. Advantages of a bath or shower is the freedom of movement that comes with it, the water in the bath causes less pressure on your back, hips and legs. Additionally relaxation causes an increase of oxytocin which can increase the efficiency of your contractions.

The TENS works with little electrical shocks which go trough special bandages trough the skin to your nerve fibers, interrupting the pain signals to the brain thus making the pain more bearable. It is possible to combine TENS with other pain medication, with the exception of water.

This treatment uses four injections with small amounts of sterile water into the lower back. The water leads to local irritation in the lower back causing the pain to decrease. If wanted the procedure can be repeated and is proved to be effective on lower back contractions.

Acupuncture uses needles to increase the production of endorphin, the natural pain killer. If you think you want to use acupuncture stimulation you will have to apply for an acupuncturist yourself. This treatment is not part of the standard package for midwivery led care.

By pressing our fingers on the skin on specific points or parts of the body pain receptors can be blocked so endorphin is released. Your partner can also learn these techniques, so he may actively help during labour.

Medicinal painrelief

It is important to be aware of the fact that any form of medicinal painkillers, with the exception of entonox, will mean we have to transfer you to the gynaecologist.  The gynaecologist will first have to determine whether your as well as your baby’s condition is severe enough for the need of painmedication. This diagnose will be based on a half hour monitoring of your baby’s heart.

The only medicinal painkilling available for us midwives is Entonox. This gas is a substance containing oxygen and nitrogen being applied using a mask. This medication will help you to relax and relieve some of the pain. The gas works within a minute and will leave the body within a couple of minutes. This option is currently only available in Bevalcentrum West due to ventilation systems unavailable in other hospitals. A few midwives at Nova are qualified to apply this method so if this has your interest you can ask information during a consult or during information meetings.

With use of a needle a morphine-like substance will be injected in your upper leg or buttocks. This medication is only supplied in the first stage of labour and preferable at least 4 hours before your baby is expected to be born. It relieves some of the pain of your contractions and lowers your consciousness making you calmer and more relaxed.

An infuse with a base dosage of morphine-like substance will be administered. When in pain it is possible to handle a little pump yourself giving you an extra ‘shot’ helping to lower the pain during contractions. The medication relieves the contraction pains and will calm you down in between contractions by making you a bit fuzzy.

The epidural is an injection close to the spine placed by an anesthetist. A little tube in your back provides you with constant pain medication. This prevents pain triggers from reaching your brain and thus making you feel less or nothing in your lower body. When the epidural can be inserted depends on whether or not there is an anesthetist available at the time of your labour. It is possible you have to wait a while in case the anesthetist is in surgery.