Updated April 2014, next review April 2017
Premature labour - pain relief
Everyone's experience of childbirth is different, so it's useful to know what pain relief is available in case you need it.
You may have a straightforward premature birth and choose to get through it without any medical pain relief at all. Some women use self-help techniques to help with pain levels, such as learning to relax and stay calm, breathing deeply and receiving a massage.
If your baby is very premature you may not have had a chance to attend antenatal classes that teach these techniques however, and if you have a complicated or lengthy labour, or an induction, you may well need stronger pain relief. An epidural or spinal is essential if you have a caesarean.
Your pain relief options for labour
A transcutaneous electrical nerve stimulation (TENS) machine is a battery-operated device with gel pads that you stick to your lower back. It works by passing a low electrical current through your body, interfering with the normal nerve impulses and reducing the pain.
Gas and air
This is a mixture of oxygen and nitrous oxide gas, which you may hear the healthcare team describe as Entonox. You inhale it through a mouthpiece just as the contraction is about to start.
If you need more pain relief, you may be offered an injection - usually of pethidine - into your thigh or buttock. This will give some pain relief and help you relax, but it may make you feel woozy or nauseous, could make your baby drowsy and cannot be given too close to the point of delivery as it may affect your baby's breathing.
When a baby is expected to be born prematurely, analgesic (pain-relieving) drugs, especially those containing morphine, are usually given as sparingly as possible, and avoided altogether within three to four hours of delivery, as they can be harmful to the baby's breathing.
Epidural or spinal
These are injections given by an anaesthetist, and are available only in hospitals. A tube is inserted into your spine and the anaesthetic goes in through the tube. The epidural provides total pain relief within 30 minutes, and can be topped up as necessary, or increased if you need a caesarean.
General anaesthetic (caesarean delivery)
When you get a general anaesthetic you are put to sleep. To many women, this idea seems far preferable to being awake during a caesarean. However, you will usually be encouraged to have an epidural instead, as this is safer for you and the baby.
How you may feel after giving birth
- After a vaginal delivery. You will feel very sore, and will have cramps as your womb contracts back to its normal size. You may be given a painkiller such as paracetamol or ibuprofen.
- After a caesarean. Following the operation your wound will hurt and you will need medicine (such as paracetamol or ibuprofen) to help ease the pain. You may also be offered something stronger, such as diamorphine.
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Henderson D, Macdonald S (2004) Mayes Midwifery (13th edition), London, Balliere Tindall
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Your pain relief options for labour
How you might feel after the birth
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'I'd asked for paracetamol because I had a backache, and the nurse came in and paged a doctor, I wasn't aware that I was in labour but they got me on the bed so I could deliver. My baby was taken away immediately. The doctor came in and told me I had a little girl and asked if I wanted everything done for her. They had the curtains closed while they were working on her, my phone was ringing next to me and I was saying: "I've had the baby."
'Looking back at it is very strange. She's five now and top of the class for reading. She's amazing.'