Relief from pain during delivery

Information to the patient / i / Pregnancy and delivery / Hospital District of Southwest Finland
 
Various contraction sensations are part of a normal delivery. The aim with the pain relief, which is given during the delivery, is to lessen the pain the mother is experiencing, not to remove all sensations. The pain relief also lessens the harmful stress reactions caused by the pain, in the mother as well as in the child. Discuss with the midwife and the obstetrician about the method for relieving pain that suits you the best.

The pain the mother experiences during the first stage of the delivery is caused by the contractions of the womb and the opening of the canal of the uterine cervix. Touching or massaging the pain spot, a warm shower, a warm bag or cooling gel lessen the contraction sensations in the opening stage. Moving about, a forward bent position and rotating the hip lessen the pain.

Other methods for pain relief are nitrous oxide i.e. laughing gas, painkillers, water blisters and acupuncture. If needed, the midwife helps choosing the method for pain relief at the right time.

Local anaesthesia in the uterine cervix and pudendal nerve block

The obstetrician gives anaesthesia in the uterine cervix and a pudendal nerve block in connection with the pelvic examination. Both local anaesthesias can be renewed if needed.

Epidural and spinal anaesthesia

During the opening stage, the mother’s pains can be the most effectively be relieved through epidural or spinal anaesthesia which are distributed by the anaesthetist. If the first stage of the delivery has proceeded relatively far, there is not always time to give epidural anaesthesia. In such cases either local anaesthesia in the uterine cervix or spinal anaesthesia (“anaesthesia of the spinal cord”) can be used.

During epidural and spinal anaesthesia the painkiller and the local anaesthetic are administered between the mother’s lumbar vertebras. In epidural anaesthesia a thin tube is left in the back, more medicine can later be administered through this tube. 

After the local anaesthesia

The anaesthesias are safe but not completely risk free. The most common side effect in connection with epidural or spinal anaesthesia is that the mother’s blood pressure goes down, which tends to be mild and does not demand any measures. If needed, the low blood pressure is treated with intravenous fluid and medication. For safety a venous cannula (a so called drip cannula) is placed in the parturient’s arm in connection with the spinal and epidural anaesthesia. After having given the anaesthesia, the parturient’s condition is followed up with among other things repeated measuring of the blood pressures. Other side effects are rare. Possible side effects are temporary head ache (1:100), passing nerve damage which is felt as a kind of pain or numbness (1:5 000) and very rarely symptoms of paralysis in the extremities (1:150 000). (As a comparison: the risk of dying in a traffic accident during one year is in Finland about 1:10 000).

When the effect of the anaesthesia has passed, the mother can experience back pains and sometimes urinating can become difficult. Afterwards the back pain can be treated with painkillers. If urinating does not succeed, the bladder can be emptied through catheterizing. The after-headache which might occur when getting up from bed can also be treated.