Pain relief in labour

Published on 09/03/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 09/03/2015

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Chapter 41 Pain relief in labour

Michael Flynn

About two-thirds of women in labour consider the pain very severe and intolerable. There is a need for antenatal preparation, with balanced information and opportunity to discuss options of analgesia.

Pain in labour

Causes

• dilatation of the cervix
• contraction and distension of uterus
• distension of the vagina and perineum
• pressure on other organs and lumbosacral plexus

Sensory pathways

• Mild pain of early uterine contractions is conducted through T11–T12.
• When the pain becomes more intense, the pathway is T10–L1.
• The cervix is also supplied by T10–L1.
• Pain in the second stage is conducted via sacral segment S2–S5.

Analgesia in labour

Non-pharmacological methods

• position/postural changes
• warm or cold packs
• massage
• hydrotherapy
• transcutaneous electrical nerve stimulation (TENS), the electrodes being placed paravertebrally at T10–L1 and S2–S4 (uses the gate control theory of pain)
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