Pain management

At STEGH, we support effective pain management. Patients are interested in a variety of pain management strategies and we work as a team with each mother to ensure that she is comfortable and that she is empowered to use strategies that best suit her. 
 
We welcome and will work alongside your chosen support system, your midwife, your friends and family. Please consider your options, discuss them with your care provider and indicate in your birthplan the pain management strategies you intend to use in labour.
 
Communicating with us will help us to partner with you in achieving your birth goals in the fullest possible manner.
 
Drug–free pain management options
  • Shower - Let the warm water soothe your back if it aches. Water helps relieve the pain and tension of labour.
  • Move Around - Change positions often to prevent tired muscles. Walking allows the baby to move further into the pelvis.
  • Music - Listen to music to relax. Bring your phone, iPod, etc.
  • Rock - Gently sway. Baby will enjoy it.
  • Breathe - Your nurse will guide you with breathing techniques.
  • Relaxation - As you breathe through each contraction, relax your muscles starting at the top of your head and work your way down to the tips of your toes.
  • Hot and Cold Packs - Relieve lower back pain and groin discomfort. Patients are welcome to bring in their own rice or oat packs. We have a microwave that can be used to warm the packs.
  • Massage - Your nurse can teach your birth partner effective back massages to relieve lower back pain. Some laboring women benefit from gentle shoulder, foot and hand massages. Also, abdominal effleurages (gentle abdominal stroking) can effectively ease labour pain. 
  • Birthing Ball - We have a large birthing ball available for patient use. The ball may help speed up labour. It encourages pelvic mobility - it allows the mother the freedom to rock her pelvis, change her position and shift her weight for comfort. It also encourages fetal descent as the mother remains sitting in an upright posture taking advantage of gravity. Sitting on the ball helps keep the fetus well aligned in the pelvis, and encourages pelvic relaxation by conforming to the mother’s body, similar to a water mattress as it provides perineal support without undue pressure.
  • Labour Tub - The labour tub is used to promote relaxation, which decreases anxiety and pain in labour. Studies have shown that laboring in water can lower the use of pain medication and epidural. The water stimulation also helps increase blood flow to your baby. Our tub is for laboring, not for delivery. If you are interested in utilizing the labour tub, let your nurse know at pre-admit or at assessment. The tub is first come, first served.
  • Sterile Water Injections - Four tiny injections of sterile water placed just under the skin in the lower back may help decrease low back pain during labour for 1-3 hours, and can be repeated. Having sterile water injections does not affect your ability to get an epidural at a later time, if requested.
 
Pharmacological Pain Management
Opiates
Opiates are a type of analgesic given to relieve pain. Opiates are given in small doses and usually administered during the early stages of labor in an attempt to avoid potential side effects for both the mother and baby. Opiates offer pain relief and do not interfere with a woman’s ability to push during labor. Unlike an epidural, an opiate does not numb the pain but instead it helps to take some“edge” off the pain. Opiates cross the placenta during labor and can produce the following side effects in the baby:
  • Central nervous system depression
  • Respiratory depression
  • Impaired early breastfeeding
  • Altered neurological behavior
  • Decreased ability to regulate body temperature
 
For these reasons, your baby might need help with breathing. The effects of the morphine can cause baby to be sleepy for the first 24 hours, interfering with feedings. 
 
Nitronox 
Nitronox is a drug, which is part oxygen, and part nitrous oxide, the medication is delivered through a mask that is applied over your mouth and nose. It will reduce pain but you will remain awake.
 
Epidural Analgesia
Epidurals are the most effective and widely accepted method of pain relief for labour and birth. A combination of local anesthetic and narcotic is injected into the epidural space to reduce or eliminate pain in the lower body. You will not experience drowsiness as you do with most other methods of pain relief. The epidural allows for ongoing pain relief through labour and birth, and is safe for the baby. Click here for more information about Epidurals, how they work, potential complications, and other questions you may have. (Reference: Sunnybrook Hospital)