Gas and air (Entonox)

TENS stands for transcutaneous electrical nerve stimulation.

Some hospitals have TENS machines available, otherwise you can hire your own. A TENS machine is usually most effective during the early stages of labour, and can help eliviate any lower back pain (which many women experience at this stage).

How it works

Electrodes are taped onto your back and connected by wires to a small battery-powered stimulator. Holding this, you give yourself small, safe amounts of current through the electrodes. You can move around while you use TENS.  

A TENS machine works by stimulating the body to produce more of its own natural painkillers, endorphins, at the same time reducing the amount of pain signals sent to the brain by the spinal cord.

Side effects

There are no known side effects for you or the baby.

An epidural is a form of local anaesthetic which numbs the nerves that carry the pain impulses from the birth canal to the brain. For most women, an epidural gives complete pain relief and can be helpful for women who are having a long or particularly painful labour, or who are becoming distressed. It is not always 100% effective though and the Obstetric Anaethetics Association estimates that as many as one in eight women who ave an epidural during labour need to use other methods of pain relief.

An anaesthetist is the only person who can administer an epidural, so they are only available in a hospital environment. You won't be able to have an epidural at home.

How it works

• A drip will run fluid through a needle into a vein in your arm.
• While you lie on your side or sit up in a curled position, an  anaesthetist will clean your back with antiseptic, numb a small area with  some local anaesthetic and then introduce a needle into your back.
• A very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the uterus. Drugs, usually a mixture of local anaesthetic and opioid, are administered through this  tube. (An opioid is a drug that binds to special opioid receptors in the body, reducing pain.) It takes about 10 minutes to set up the epidural,  and another 10 to 15 minutes for it to work. It doesn't always work  perfectly at first and may need adjusting.
• After it has been set up, the epidural can be topped up by your  midwife, or you may be able to top up the epidural yourself through a machine.
• Your contractions and the baby's heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby's head.

Side effects

There are some possible side effects to be aware of:

• You may be unable to move your legs or they may feel heavy, depending on the local anaesthetic used.
• An epidural shouldn't make you sick or drowsy.
• Your blood pressure can drop (hypotension), however, this is rare as the fluid given through the drip in your arm helps to maintain good blood pressure.
• Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have  to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby's head (instrumental delivery). When you have an epidural, your midwife or doctor will wait longer for the baby's head to come down (before you start pushing). This reduces the chance that you will need an instrumental delivery.
• You may be fitted with a catheter to help you urinate.
• About one in 100 women gets a headache after an epidural.
• Your back might be a bit sore for a day or two, but epidurals don't cause long-term backache.
• About one in 2,000 women feels tingles or pins and needles down one leg after having a baby. This is more likely to be the result of childbirth itself rather than the epidural.