Gas and air (Entonox)
This is a mixture of oxygen and nitrogen oxide. Gas and air will not alleviate pain, but it can help to reduce it and make it more bearable.
Many women like it because it is easy to use and they arrange it themselves.
You breathe in gas and air through a mask or mouthpiece that you hold.
The gas takes about 15-20 seconds to work, so you breathe it in as soon as a contraction starts. It works best if you breathe slowly, deeply.
There are no harmful side effects for you or the baby, but you can feel lightheaded
Some women notice that this makes them feel sick, sleepy, or unable to concentrate – if this happens, you can stop using it.
If gas and air do not provide you with sufficient pain relief, you can also request an analgesic injection.
Pethidine injections during delivery
This is an injection of the drug pethidine in your thigh or buttock to relieve pain.
It can also help you relax. Sometimes, less often, a drug called diamorphine is used.
It takes approximately 20 minutes to work after the injection. The effects last between two and four hours, so it is not advisable if you come close to the pushing (second) phase of the birth.
There are some side effects you need to know:
- it can make some women woozy, sick and forgetful
- If pethidine or diamorphine is given too close to the time of delivery, they may affect the baby's breathing – if this happens, another drug will be given to reverse the effect
- the medication can disrupt the baby's first feeding
An epidural is a special type of local anesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It shouldn't make you sick or sleepy.
For most women, an epidural gives complete pain relief. It can be useful for women who have a long or particularly painful birth.
An anesthesiologist is the only person who can give an epidural, so it is not available at home.
If you think you want one, check whether anesthesiologists are always available at your hospital.
How much you can move your legs after and epidural depends on the local anesthetic used. Some units offer & # 39; mobile & # 39; spinal cord, which means that you can walk around.
However, this also requires remote monitoring of the baby's heartbeat (by telemetry) and many units do not have the equipment to do this.
Ask your obstetrician or mobile epidural is available in your local unit.
An epidural can provide very good pain relief, but it is not always 100 percent effective during delivery.
The Obstetric Anesthetists Association estimates that one in eight women who have an epidural during delivery must use other analgesic methods.
How does an epidural work?
To have an epidural:
- a drop will make fluid flow through a needle into a vein in your arm
- while lying on your side or sitting upright, an anaesthesiologist cleans your back with antiseptics, anaesthetises a small area with some local anesthesia, and then inserts a needle into your back
- a very thin tube will be guided through the needle in your back near the nerves that carry pain impulses from the uterus. Drugs (usually a mixture of local anesthetic and opioid) are administered through this tube. It takes about 10 minutes to set up the epidural and another 10-15 minutes to work. It does not always work perfectly in the beginning and may need to be adjusted
- the epidural can be supplemented by your midwife, or you can supplement the epidural yourself via a machine
- your contractions and the baby's heartbeat must be monitored continuously. This means that you have a belt around your belly and possibly a clip at the baby's head
Side effects of epidurals during delivery
There are some side effects you need to know:
- An epidural may cause your legs to feel heavy, depending on the local anesthetic used.
- Your blood pressure may fall (hypotension), but this is rare because the fluid that is delivered through the drop in your arm helps to maintain good blood pressure.
- Epidurals can extend the second phase of delivery. If you can no longer feel your contractions, the midwife must tell you when to push.
- You may find it difficult to urinate due to the epidural. If this is the case, a tube called a catheter can be put in your bladder to help you.
- About one in 100 women gets a headache after an epidural. If this happens, it can be treated.
- Your back can be a little sore for a day or two, but epidurals do not cause prolonged back pain.
- About one in 2000 women feels tingling or pins and needles along one leg after having a baby. This is more the result of the birth itself than of the epidural. You will be advised by the doctor or midwife when you can get out of bed.
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