Pain relief and having a baby

Surgery can be performed during pregnancy and breastfeeding. Your anaesthetist will assess you and tailor your treatment to your individual needs. They’ll also be happy to talk you through the process and answer any questions you have.

Your midwife and obstetrician will help you to manage mild and moderate birthing pain. But if you need stronger, longer lasting relief or require a caesarean delivery they will need to ask an anaesthetist to join your birthing team. Anaesthetists are available at major hospitals, but if you’re planning to have your baby at a smaller hospital, you should check with your midwife or GP.

You’ll usually be able to have skin-to-skin contact with your baby straight away, and start breastfeeding as soon as you feel ready.

You may require pain medication after giving birth. Most pain medication will be OK to take while breastfeeding, but your birthing team will discuss this with you at the time.

To help you with your pain when you go into labour, your midwife will usually suggest starting with some simple relaxation techniques such as stretches, massages, and breathing exercises. These may be familiar to you from antenatal classes. They can help you to feel more comfortable and in control of your contractions. If your partner is with you, they can also get involved.

Breathing a mixture of oxygen and nitrous oxide gas (commonly called “happy gas” or “laughing gas“) can help you to control your contractions and feel more relaxed. The gas is generally delivered through a mouthpiece which you can put in and take out at any time to control the flow. You’ll still be fully aware, and able to move and experience sensation.

If you start experiencing more severe discomfort, your obstetrician can give you an opioid-based pain medication such as morphine. This is generally injected into your muscle tissue. Opioids delivered in this way are generally safe to use at any stage of labour. They allow you to stay fully aware and able to experience sensation. They can provide highly effective and almost instant pain relief, but their effects are relatively short lasting.

If the happy gas and morphine aren’t keeping you comfortable enough - or there’s a chance you’ll require a caesarean delivery - your obstetrician may ask an anaesthetist to join your birthing team to provide stronger, longer lasting pain relief such as epidurals.

If the happy gas and morphine aren’t keeping you comfortable enough - or there’s a chance you’ll require a caesarean delivery – your obstetrician may strongly recommend an epidural. There are also some medical reasons – such as if you’re having twins or have high blood pressure - that make epidurals necessary.

Your anaesthetist will inject local anaesthetic – usually mixed with an opioid-based medication such as fentanyl – into the space around the spinal nerves in your lower back. This blocks the pain signals from contractions and cervical dilation travelling to your brain.

A fine plastic tube known as an “epidural catheter” is threaded through the epidural needle. This needle is then removed, leaving only the catheter, which is taped to your back and can be used to give more pain-relieving medication.

As a general rule, you can request an epidural at any stage during labour provided there are no medical reasons that would prevent you from having one, and following consultation with the midwife and/or obstetrician. It usually takes between 15 and 30 minutes to insert an epidural. Local anaesthetic is then given through the epidural, with pain relief starting  about 10 minutes later.

If a caesarean delivery is necessary, your anaesthetist can use the epidural to provide anaesthesia, making your body numb below the chest. Because this is a surgical procedure, the anaesthesia will be a lot stronger and  your anaesthetist will be with you for the entire time. You’ll usually be awake for the experience, except for those situations requiring general anaesthesia.