Pain medication

Attitudes

Every woman experiences birthing pain differently, so it varies from person to person which position is most comfortable. It is often a matter of trial and error. In this leaflet you will find some examples of positions you can adopt during childbirth, both during the dilation phase and while pushing.

See also KNOV leaflet on posture

Massage

During your labor, you may experience pain in your lower back or legs. This is due to the increasing pressure of the baby's head on your pelvis. Having your partner or us massage these areas to provide some counter pressure can be pain relieving.

Bath or shower

Warmth allows you to relax better. That relaxation is what your body needs to produce endorphins, a hormone that acts as a natural painkiller. Benefits of bath or shower are that you have more freedom of movement. Your abdomen feels less heavy in the bath, and it relieves pressure on your back, hips and legs. Furthermore, the relaxation increases oxytocin, so your contractions are often more effective in the bath.

TENS (transcutaneous electrical neurostimulation)

The TENS works by sending an electric current through special patches, through the skin, to the underlying nerve fibers. This interrupts pain signals to the brain and you experience less pain. The TENS can be used in combination with other pain management methods, with the exception of water.

Sterile water injections

This is a treatment in which four injections are given in the lower back with a small amount of sterile water. It creates a localized irritation in the lower back, thus taking away some of the pain. The treatment can be repeated as desired and is particularly effective for back contractions.

Acupuncture

Stimulation through needles to help the body produce as much endorphins as possible. An acupuncturist will have to be requested by you yourself; this is not included in the standard package for obstetric care.

Acupressure

Pressure point massage on specific areas of the body. By pressing our fingers on certain points of your skin, pain receptors are blocked and endorphins are released. The techniques used can also be learned well by your partner, giving your partner a distinct role during labor.

It is important to note that all forms of medicinal pain relief, with the exception of nitrous oxide, means that we must turn your care over to the gynecologist. The latter will first want to determine whether both your condition and the baby's condition are sufficient to administer pain medication. This is done by means of a heartbeat of the baby and takes about half an hour.

Nitrous oxide

Nitrous oxide is the only form of medicinal pain relief that we as obstetricians are allowed to give to you. It is a mixture of nitrogen and oxygen administered through a mask. It helps you relax and reduces the top of the pain. Nitrous oxide works within 1 minute and is out of the body within minutes. The option for nitrous oxide is currently only available at Birthing Center West. This is due to the ventilation systems not being suitable for nitrous oxide at the other hospitals. Some midwives at Nova are licensed to give nitrous oxide so if you are interested, feel free to inquire about it during the consultation or information night.

Pethidine

A morphine-like medication is administered into your thigh or buttock through a hypodermic needle. This medication is given only in the dilation phase and preferably more than 4 hours before the expected birth of your baby. It reduces the pain of the contractions and reduces the level of consciousness so you often experience more peace.

Remifentanil

Remifentanil is also called the pain relief pump. Through an infusion you receive a basic dose of morphine-like medication. Through the pump you can give yourself an extra shot which helps you through the next contraction. The medication takes the edge off the contractions and gives you more rest between contractions because it makes you a little drowsy.

Epidural

The epidural or epidural is a puncture close to the spine. It is placed by the anesthesiologist. Through the tube that the anesthesiologist leaves in your back the painkilling fluid is given. This ensures that the pain stimuli no longer go to your brain, so you feel little to nothing in your lower body. However, you do depend in your labor on when the anesthesiologist has time to place the epidural. In case of emergency surgery, you may have to wait a while.