It is possible for yourself to work with the contractions and relieve some of the birth pain both early and late in the birth process – at first in your own home and later in the Maternity Ward together with a midwife.

Anxiety is known to increase the experience of pain, and therefore it is important that you feel comfortable both before and during the birth. You may attain some of this comfort by joining our prenatal offers to gain knowledge of the birth process and the opportunities we have to offer. Speak with your consulting midwife about your expectations, wishes and concerns regarding the birth – and later on at the Maternity ward, you can also get advise by the midwife guiding you.

During the birth many women benefit from the father – or possibly another close person – to provide support and care.

The midwife will to the most possible extent take your wishes, reactions and needs into consideration. We strive to make the birth progress as naturally as possible, and with respect to this we offer peace, individual care, breathing assistance, relaxation in a bath tub, acupuncture and pain management as needed, e.g. morphine and epidural anaesthesia (epidural block).

You are participating in the decisions regarding these offers, and in advance the midwife will inform you about advantages and disadvantages.

It is our experience that the women’s needs, once the birth has begun, can be different from what she imagined before the birth. 

It is good to use your body during the birth, since this may have a pain relieving effect and support the rotation of the foetus down through the pelvis.

Some birthing women need to be in motion during the birth pains, while others prefer to lie on the side, stand on all fours, or to change between different positions. Sometimes you may need to be active, and sometimes you may need to stay rested.

Pain can release tension in all the body – also in the pelvis where the contractions are pushing the foetus further down through the birth canal.

A deep and calm breathing may have a relaxing, calming and pain relieving effect. Once the body is relaxed, the uterus will have the best conditions to work, which means that the birth is progressed.

Music may have a relaxing effect and you are welcome to bring along your own music.

When feeling lower back pain, massage can have a soothing effect. Touching has a relaxing effect and provides a feeling of comfort. Some women may however experience that touching during birth pains is uncomfortable.

During the birth process you may benefit from residing in water. This is done best in a bath tub where you can easily move around and find exactly the positions that are most comfortable to you.

The temperature of the water should be as close to body temperature as possible. If the temperature exceeds 37°C, it may be uncomfortable, and both you and the foetus could get an increased body temperature if it continues for a long time. If the temperature is lower than body temperature, the relaxing effect may be reduced.

In case the birth begins at home, a warm shower head may have a soothing and relaxing effect.

If you want a delivery room with a bathtub, please inform about this when you contact the Maternity Ward.

You may give birth in water when:

• You have had a normal pregnancy

• You are expecting a normal birth of a child in head position

• The birth is taking place from week 37 onward

• The amniotic fluid is clear

• The birth continues to progress normally

• You are able to come in and out of the bathtub on your own, or with the help of your partner

Sterile water injections / ‘bee stings’

Sterile water injections are sterile water being injected under the skin as little bee stings in order to relieve lower back pain.

Sterile water injections are not medicine, they work by blocking pain impulses from the uterus to the brain. They last for 1-2 hours.

The injections will give a stinging/burning sensation that will last for about 30 seconds, and you will immediately be able to feel the pain relieving effect. 

Oxygen

Pure oxygen from a mask has an effect in several ways – partly by making the
respiration more calm and focused, and also by improving the oxygen supply to the muscles. 

Acupuncture

Acupuncture is an ancient Chinese treatment method which can be used
throughout the entire birth process – partly as a means to relaxation and partly as pain management. Acupuncture doesn’t affect the foetus. The effect is obtained by inserting very thin needles into the different energy points of the body.

Typically, acupuncture needles are inserted into several points and often left there for several hours, and from time to time the energy points are stimulated by turning the needles. Hereby, the sensation of pain will change. Complete painlessness can however not be obtained. Acupuncture is not equally effective on all. If the desired effect is not obtained, it will be necessary to choose another type of pain management.

In some situations medical pain relief will be the appropriate choice to both your experience and to the process of the birth. This decision is made together with a midwife.

The initial phase of the birth process, can be long and the pain may seem unbearable although it may not be particularly strong.

In this situation it may be necessary, to offer you analgesics or sleeping medicine, in order for you to gain enough energy and rest and gain strength to get through the rest of the birth.

Morphine is an analgesic remedy that works by affecting the brain’s perception of pain. It is given as an injection.

Morphine can be provided during the first half of the birth in order to curb the worst part of the pain and help to get rest and gain energy.

Morphine has a soothing and slightly sedative effect. You will often become more indifferent to the pain. Morphine may cause sideeffects such as nausea, vomiting, dizziness and itching of the skin. The effect will last for 1-3 hours.

The newborn baby may be momentarily affected in terms of drowsiness with difficulty breathing. The initial mother/child contact may be inhibited and thus delay breastfeeding. In order to avoid this, morphine is not given when assessed that there are less than 4 hours to the birth.

In case the newborn still has difficulty breathing as a result of the morphine, an antidote can be given which neutralizes the effect of the morphine.

Nitrous oxide (laughing gas) is relaxing and easy pain relief. Used in the last part of the birth when the cervix is 6-7 cm open.

Nitrous oxide is administered by inhaling it through a mask. Nitrous oxide is achieved only after 2-3 minutes and it is therefore important that you breathe into the mask before the contraction begins. You need both breathe in and breathe out into the mask to avoid high levels of nitrous oxide in the delivery room.

If you drop the mask, it is important to keep it just below the chin as laughing gas remains sucked into the ventilation system.

Nitrous oxide is from the body in the course of a few minutes. Your child also gets some nitrous but secrete it quickly just like you.

The side effects of Nitrous oxide is slight headache, nausea and euphoria. There are no side effects seen in the child. Euphoria can be experienced pleasant for anyone and uncomfortable for others. We therefore maintain short breaks in between where we ensure that you are well.

An epidural block is a local anaesthesia given in the lower back in order to achieve pain relief during the dilatation period.

The epidural is given by an anaesthetist.

Prior to the epidural the birthing woman will be given a saline drip, and the bloodpressure and temperature will be measured. After numbing the skin on the lower back with local anaesthesia, a very thin catheter is inserted through a special needle. The catheter is inserted into a cavity right behind the spinal canal (the epidural space) – and hereafter the needle is removed. The epidural catheter is attached to the back with tape, and it will stay there throughout the birth.

The epidural is given while you are sitting up. It will be necessary to sit completely still for the 5-10 minutes while the epidural is given.

When the epidural catheter i inserted the midwife will monitor your blood pressure and the foetus will be monitored using an electronic foetal monitor.

You can move freely in bed, and many times you will also be able to stand up with support after a shorter observation period.

Most women will have good effect from the epidural. In a very few cases it will not be possible to place the epidural catheter in the right place. In that case the birthing woman will be offered another kind of pain management.

The epidural may not be used simultaneously with residing in a bath tub.

Sometimes waiting time may occur if the anaesthetist is occupied by an emergency.

Side effects of the epidural block

The most common side effect is a momentary drop in the blood pressure. The blood pressure is frequently measured, especially in the beginning, and you will be given medication that will immediately bring your blood pressure back up in case it shows a downward tendency.

The sensation of a full bladder may be impeded making it difficult to feel urinary urgency. It is important that the bladder doesn’t become overfilled. Thus, it may be necessary to empty the bladder with a catheter.

The epidural may prolong the duration of the birth, and it may be necessary to use a oxytocin drip stimulating the contractions.

The urge to push may be impeded which means that the risk of having to use a vacuum extractor during the birth will be slightly increased.

In a few cases temporary pain or soreness may occur from the area in which the epidural has been given. These inconveniences will disappear by themselves during a few days.

1-4% women will get a headache after having an epidural block. The headache can be very strong and may occur up to three days after the epidural has been given. There is an effective method to treat this kind of headache. Thus, it is important that the woman contacts the Maternity Ward in case the headache starts after being discharged.

Itching of the skin may occur but is rarely so troublesome that treatment will be needed.

An epidural will not increase the risk of having to perform a C-section.

A pudendal block is a local anaesthesia that is given during the pushing period of the birth when the baby’s head is pushing against the perineum. The pudendal block has its effect by diminishing the sensation of distension and pain in the perineum and the lower part of the vagina.

It is given when the birthing woman has found the right pushing technique.

The anaesthesia will last for 1-2 hours and will also have an effect in case of cutting and stitching in the perineum.

The baby will not be affected by a pudendal block.

The local anaesthesia is given after the birth, provided that the birthing woman needs stitching and a pudendal block has not been given.

The sense of pain is numbed, but since the sense of touch cannot be removed, some birthing women may still experience the stitching as uncomfortable.

Local anaesthesia of the perineum will only have an effect in the exact point where it is given.

We hope that you have found answers to some of your questions about pain relief during birth.

If you wish to have the information elaborated, you may speak with your midwife in the consultation office or the midwife who is going to be with you when you arrive to the Maternity Ward.