Being aware of your options during labour is the best way to prepare yourself for a better birth
Worried about how you’ll cope with the pain during labour? Of course you are, but by controlling your fears you’ll help yourself to a better birth.

The more frightened and anxious you are, the more adrenaline your body will release, which can slow down contractions and prolong labour. Nothing beats good preparation, so attend as many antenatal classes as possible, read about your pain relief options and discuss your expectations of labour with your ob-gyn.

Try to have an open mind, if your labour doesn’t go to plan and you understand your options, you’re less likely to panic. But if you’re undecided or unsure about what methods of pain relief are available to you or what will suit you best, here’s the low-down.

PETHIDINE
What it does
Pethidine is a painkiller, similar to morphine, that will help to relax your muscles and make you feel less aware of the pain. It’s administered during the first stage of labour, when your cervix dilates and before you start pushing.

How it works
An anaesthetist will inject the Pethidine into your bottom or thigh. It can also be given through a tube inserted into a vein in your arm and is sometimes combined with an anti-sickness drug to control any nausea you might feel.

The pros
Pethidine is administered by an anaesthetist and can be used for a home birth. It can make you feel relaxed and less aware of the pain, and more able to cope with your contractions.

The cons
It might make you feel dizzy, sick and sleepy and stays in your system for around four hours. It takes around 20 minutes to start working so you might feel drowsy in between contractions, then wake up as the pain kicks in. It might also slow down your labour and you can’t have it too close to the actual birth, because it can affect your baby’s breathing and she might need an injection afterwards to reverse the effects of the drug. Your baby might also be quite sleepy and feed more slowly for the first few days.

WHAT THE EXPERTS SAY
“Pethidine is a strong painkiller and can make the child sleepy, so we avoid it when the woman is likely to deliver soon. If you are likely to deliver within four hours, a smaller dose of Pethidine is safe. But a simple painkiller  like Tramadol can also be effective. It blocks the pain fibres and reduces discomfort and pain. We use it in post-operative cases as well,” says gynaecologist Dr Vikram Shah. The cost of Pethidine does not amount to much and is usually done for free. “I personally don’t like to use Pethidine because it reduces capacity and alters the patient’s sensorium. It doesn’t allow the patient to push down too well,” says gynaecologist Dr Ranjana Dhanu.

What you might not know
Pethidine can be given in three different doses – 50mg, 100mg, and 150mg. So, if normal painkillers, such as paracetamol or aspirin, have quite a strong effect on you, ask for a low dose. This will help you to avoid feeling completely out of it.

GAS AND AIR (ENTONOX)
What it does
Entonox, more commonly known as gas and air, is an odourless, colourless mixture of oxygen and nitrous oxide. It’s the most common method of pain trelief and while it won’t remove the pain completely, it will help you to detach from it, making it easier to cope with.

How it works
You hold a rubber mask over your mouth and nose, or a mouthpiece in between your lips and breathe in deeply. It takes around 20 seconds to build up in your blood stream before making you feel a little light-headed. It will help to distract you from the discomfort of your contractions and within a minute, you’ll feel normal again.

The prosYou can have gas and air at whatever stage of labour you want. It’s easy to use and you’re in total control of how much you breathe in. It contains oxygen, which is good for both you and your baby and it won’t stay in your system. Best of all, using gas and air won’t stop you from having any other method of pain relief if the pain becomes unbearable.

The cons
It’s only a mild painkiller, so the pain won’t disappear completely. It might also dry out your mouth or make you feel sick and light-headed. It’s really important that you breathe in the Entonox correctly – start breathing it in as your contraction builds so that you get maximum pain relief when it hits its peak.

WHAT THE EXPERT SAYS
“The laughing gas or Entonox can be inhaled when the woman feels she can’t tolerate the pain. It is would just take away the edge of the pain and is self controlled. Inhaling more will make you dizzy, so the mask can be removed. But it won’t have any side effect on the child. It is used only during contractions,” says Dr Shah. The cost of entonox is included in the delivery package.

What you might not know
Don’t worry about gas escaping from the mask when you take it off after each contraction. All hospitals have ‘scavenger systems’ that immediately remove any gas that might escape into the delivery room. So there’s no danger that your ob-gyn will feel as light-headed as you!