Return to index
Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier
A clear distinction should be made between the traditional goal of pain relief and control of pain in labour. The aim should be to give the woman control of pain rather than trying to eradicate it. This may require a multifaceted approach that includes pharmacological and non-pharmacological methods.
Non-pharmacological methods of pain control
A Cochrane review of studies involving acupuncture, acupressure, aromatherapy, massage and relaxation techniques found that acupuncture reduced the need for analgesia; women taught self-hypnosis had decreased need for pharmacological analgesia; no differences were seen for women receiving aromatherapy. Few other complementary therapies have been subjected to scientific study. In the UK, the National Institute for Health and Care Excellence suggests that breathing and relaxation techniques, and massage, may be helpful and have no side effects. Women should be offered the option of being in water during labour as this helps with pain. Acupuncture, acupressure or hypnosis are not available on the NHS, but women can use these techniques if they wish. Starting to use a TENS machine once the woman is in established labour will not help with pain.
Pharmacological methods of pain control
The Practising Midwife featured articles
Cochrane Corner: Inhaled analgesia for pain management in labour 2012; 15(9): 42 - 43 Author: Declan Devane
Optimising Endorphins 2012; 15(10): 33 - 35 Mavis Kirkham, Margaret Jowitt
Cochrane Corner: Early versus late initiation of epidural analgesia for labour 2014; 17(11): 30 - 32 Valerie Smith
Cochrane Corner: Oral analgesia for relieving post-caesarean pain 2016; 18(6): 34 - 36 Valerie Smith
Royal College of Midwives. (2012) Evidence Based Guidelines for Midwifery-Led Care in Labour: Understanding pharmacological pain relief. https://www.rcm.org.uk/sites/default/files/Understanding%20Pharmacological%20Pain%20Relief_0.pdf
Tidy C. (2015). Pain relief in labour (Professional reference). http://patient.info/doctor/pain-relief-in-labour
NICE (2014). Intrapartum care for healthy women and babies (CG190) - Information for the public. https://www.nice.org.uk/guidance/cg190/ifp/chapter/pain-relief