Having confidence in your own body will assist you through labour. While you are in the early stages of labour you may like to try some ways of helping yourself cope with the pain. For example a warm bath can be very relaxing, or your partner could massage your back. Some women find keeping active by walking about helpful and adopting positions of ease during contractions. Breathing and relaxation techniques can be beneficial. Complementary therapies such as aroma therapy, massage and reflexology may also help.

If you would like to use complementary therapy methods of pain relief in labour please discuss this with a midwife from the complementary therapy team.

The benefits of using water for labour are now widely recognised. There is a pool available in the Labour Ward for use by women in labour when the pregnancy and labour is problem free. If you want to use the pool there are guidelines that your midwife can make you aware of; these will achieve the maximum benefits, ensuring the safety of you and your baby.

TENS produces a massage effect through the application of small pads placed on your back which stimulates the release of endorphins which are natural pain relieving chemicals found in the body. TENS can also be used with other forms of pain relief such as gas and air and Pethidine injection. The advantages are that this form of pain relief has no side effects for you or your baby, you can still walk about, and you can operate the strength of the electrical massage so it is very easy to use.

If you are interested in using TENS please ask your midwife for a TENS form at the Antenatal Clinic, or contact the Physiotherapy Department at the Ulster Hospital to book a session on how to use TENS. Alternatively you may like to hire your own TENS machine, if so ask a midwife or contact the physiotherapy department on 028 9048 4511, ext 2353.

This is a mixture of oxygen and nitrous oxide similar to what you may have used at the dentist. You control when you want to breathe the gas and air through a mouthpiece or mask. As soon as a contraction begins you need to start breathing the gas to maximise the effect as it takes 15 to 20 seconds to take effect.

Some women find gas and air is all they require for pain relief during labour and it has no side effects for the baby as the gas is expelled quickly when it is breathed out. However gas and air may make you feel temporarily light headed, sick, or sleepy.

These are sedatives which can be given to help you cope with your contractions by helping you to relax and some women find they lessen the pain. Pethidine takes approximately 20 minutes to work, the injection is given into your hip and the effect of the injection usually lasts between two to four hours.

Omnopon is usually used in the early stages of labour with your first baby. Its pain-relieving effects can last up to six hours. However the side effects are: it can make you feel very woozy, sick and forgetful. You may also find it difficult to push in second stage. It may affect the baby's breathing and if this happens the baby will be given medication to reverse the effects.

An epidural is an injection which is given into the lower back by an anaesthetist. It is a mixture of local anaesthetic and pain-relieving drug. It takes about 20 minutes to set up the procedure and another 15 to 20 minutes to begin to work or take effect. A fine tube is left in your back so that further doses can be given. An epidural can be very helpful for those women who are having a long and particularly painful labour. However you need to be aware that approximately 1:20 epidurals do not work well and may need to be put in again.

Greatly reduces pain of labour.
If the obstetrician decides you need forceps or a vacuum delivery it provides good pain relief.
If the obstetrician decides you need a caesarean delivery the epidural can be 'topped up', avoiding the need for general anaesthesia.
With raised blood pressure (pre-eclampsia) the epidural helps stabilise the swings in blood pressure.

You will need a drip in your arm and a catheter in your bladder.
Sometimes the epidural can cause a fall in blood pressure which can make you feel sick or dizzy.
The epidural drugs may cause your skin to itch and you may experience episodes of shivering.
Sometimes the epidural works on one side only and may need to be put in again.
Sometimes after epidural you may get a severe headache. This occurs in around one per cent of epidurals. It may require further treatment.
Your legs may become slightly heavy and your ability to push will be affected. The second stage of labour is usually longer and a forceps or vacuum delivery may be more likely.
Serious side effects, such as nerve damage is rare. For example, prolonged patches of numbness are said to occur in about 1:13,000 epidurals.

Do feel free to discuss any concerns you may have about epidurals with your midwife and if necessary she will arrange for you to speak with an anaesthetist antenatally.

Remifentanll is a very short-acting pain relieving drug like pethidine. Its pain relieving effect comes on very rapidly and also wears off very quickly. It is self administered through a hand held pump.

You are in control
You are more alert throughout your labour
There is a safety feature built into the pump so you can only get a safe amount of the drug
Some women can still get sleepy between contractions but Remifentanll has been shown to be safe for babies