Pain relief

Childbirth is always accompanied by pain. Nobody can ignore that. The perception of pain during childbirth varies per person and even per delivery. So no one can accurately predict how much pain you will have and how you can best deal with it. During pregnancy, it is important to prepare well, together with us, for the unknown and unpredictability of childbirth. Providing good and sufficient information about childbirth and pain perception are important for a satisfactory delivery. Following a pregnancy course can make a good contribution to this. Refer below for more preparation, natural pain relief and pain relief through medication.

Prepare well

Read leaflets, magazines, books about giving birth. Take a pregnancy class and start practicing some breathing techniques. Good information and preparation often mean that you can relax better during childbirth. This will reduce the pain.

If there is good support during labor, you can deal with the pain better. Think about who can best support you during the childbirth. This can be your partner, but also your mother or a good friend. Discuss your fears and preferences with him/her beforehand. Then you can focus your energy on dealing with your contractions during the delivery. The midwife, and sometimes the maternity nurse, will of course also offer you support during the delivery.

Make sure you start labor rested. Go on maternity leave on time, get enough sleep and make sure you take enough time for yourself in the last few weeks. Because if you are rested, you can handle pain better.

Natural pain relief

Your body itself produces the so-called “endorphins” that have a pain-relieving effect. This natural pain reliever can make your labor pain more bearable. Some rest and a comfortable environment accelerate the production of endorphins. In addition to the natural production of endorphins, there are also other tips and means that you can apply in every situation to better deal with the pain of labor.

At the beginning of the delivery, the contractions are often not that strong yet. Try not to pay too much attention to the pain at this stage and look for distraction! Keep doing what you were doing for as long as possible.

As labor progresses, the contractions will become more difficult to handle. It is important to find a position in which you can relax the best and thus better master the pain! It is also good to change position regularly during labor. This often also helps the dilation. Let everything hang as loosely as possible and keep breathing calmly. For example, use a bed, chair, bath, shower, changing table, banister and pillows.

Concentrate on your breathing. When you follow the rhythm of your breathing, you are less focused on the pain. This helps you to relax. Ask your partner to help you breathe if you have lost the right rhythm or if you start to panic.

Heat helps to relax. Make sure you have a pleasant room temperature. Put on warm, comfortable clothes. If necessary, use a hot water bottle or enjoy the heat of a shower or bath.

When the contractions get stronger, massage of the lower back or thighs can be pleasant. Sometimes women not only experience pain in the abdomen, but also pain in the back and / or thigh. Try it out and see if massaging works! Sometimes the concentration is at its best when you are left alone and no one touches you.

Think positive. Believe that you can handle the delivery! Remember that every contraction brings you closer to having your baby. Often there is also a moment during childbirth when you don’t feel like it anymore. Do not be angry or disappointed with yourself. Let your partner encourage you or ask us for advice.

Pain medication

Sometimes it happens that the pain is unbearable despite all natural pain relief attempts. Then there is an option to get medication for the pain, but you have to be in hospital first. In the hospital, they have to closely monitor your and your baby’s condition when administering pain relief.

Pethidine is given by injection into your buttock or thigh. It is similar to morphine, it takes effect within half an hour after administration and will last for 2 to 4 hours. Pethidine does not completely take away the pain, but it does take the edge off the pain.

Pros

  • Pethidine can be given at any time in any hospital.
  • About 50% of women are satisfied with the relief it provides.
  • Pethidine can make you sleepy and you may doze off between contractions.

Cons

  • Pethidine doesn’t work that fast.
  • It takes half an hour for the worst pain to diminish.
  • About 25-50% of women find that the pain decreases.
  • You can feel nauseous, drowsy and sleepy.
  • You may experience the birth of your baby less consciously as a result.
  • Because of the side effects for your baby, pethidine is no longer administered in the final stages of dilatation.
  • Your baby may also become drowsy from the pethidine. Sometimes babies need an injection to breathe properly.
  • You are not allowed to walk around anymore, because you are less stable and may fall.

An epidural is an injection into your lower back with a combination of pain-relieving drugs. With this pain treatment you no longer experience pain in your lower body. The anesthetist inserts a needle in your back under local anesthesia. You must make your back convex and lie or sit still (also during contractions). A thin, flexible tube is placed in your back via the needle. The needle comes out again, the tube remains. Through this tube you will receive pain-relieving medication during the entire delivery. It takes up to 15 minutes for the medicine to work.

Pros

  • Most women (95%) no longer feel pain at all during contractions.
  • As far as is known, an epidural has no adverse consequences for the baby or breast-feeding.
  • An epidural does not make you sleepy or drowsy, so you experience the delivery consciously.

Cons

  • Sometimes an epidural only works on one side of your body. And in roughly 5% of the women, the pain does not or hardly diminish. This may be due to the location of the needle and the dosage of the medicines. Sometimes, the epidural is removed and a new one is set.
  • Childbirth, especially the pushing part, takes longer. As a result, there is also an increased chance of an artificial delivery.
  • The contractions must be supported with additional medication more often (additional stimulation).
  • You are not allowed to get out of bed, because you have less / no feeling in your legs. That feeling will slowly return after the administration of the drug is stopped.
  • An IV will be put in to prevent your blood pressure from getting too low.
  • Usually you will receive a bladder catheter because the anesthesia does not make you aware when you need to urinate. This will be removed after delivery.
  • Your body temperature may rise due to the epidural. It is then difficult to determine whether this is due to the epidural or whether it is a fever caused by an infection. Sometimes you will be given antibiotics just in case. There is a chance that your baby will be admitted to the pediatric ward after an examination by the pediatrician and will also be treated with antibiotics.
  • Sometimes you may need to wait for the epidural. If the anesthetist is busy you have to wait for him/her to finish. Emergencies will take priority over you.
  • You can get itchy. This can be treated well by adjusting the composition of your medicines.

The new remifentanil is a morphine-like substance that is administered through a tube in the arm (IV), which is attached to a pump. You can determine the amount of remifentanil you want to receive with a push button. The pump is adjusted in such a way that you can never give yourself too much.

Pros

  • Remifentanil already takes effect after 1 minute.
  • Remifentanil is a better pain reliever than pethidine (but less effective than an epidural).

Cons

  • Remifentanil can affect your breathing and the amount of oxygen in your blood.
  • With remifentanil there is a small risk of respiratory arrest in the mother. That is why you and your baby will be continuously and carefully monitored while using this medicine.

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