Analgesia

Giving birth is painful, something no one can deny. But how bad the pain will be and how you cope with it, is very difficult to predict. Every birth is different. Do not worry about it; there are many ways to ease the pain. For some relief means a hot shower or hot water bottle while being in a calm and warm environment (for optimal relaxation). So that the pain relieving hormones, created by your body can do their work. And others may have a need for pharmaceutical pain relief to make the birth bearable. The hospitals we work with have 24 hours a day analgesia available during labour. There are three kinds of analgesia: epidural, laughing gas (entonox) and remifentanyl.

 

Epidural

If you require pain relief during labour and you are not too far along in the process, we will arrange this for you. In that case we must hand you over to the care of the gynaecologist and it will be then considered a medical birth. This means that we cannot assist you any further. If you have questions about analgesia or you are sure about wanting pain relief before going into labour, please discuss this with us. For more information on childbirth, we refer to the brochure: ‘Jouw bevalling: hoe ga je om met pijn?’ (Your childbirth: how do you deal with the pain?

In the early stages of childbirth an epidural provides the best and most lasting form of pain relief, although an epidural may have side effects. It may cause a rise in body temperature for you, which can result in the baby having to stay overnight to check for any infections. There is also the chance for needing an IV containing a hormone to make your contractions stronger. Also a ventouse delivery (suction cup) may be the only option as you might not be able to feel the contractions as strongly. For the option of an epidural to be suitable, it is imperative that you receive extra moisture through a saline IV and that the baby and your contractions are monitored continuously. The epidural should be performed by an anaesthesiologist.

 

Laughing gas (entonox) as pain relief

Laughing gas is a mixture of (di)nitrogen (oxide) (N2O) and oxygen (O2). Entonox is a different name for laughing gas. You only give yourself laughing gas during a contraction through a mouth / nose mask. You get a cap over your nose and mouth, a chin mask on and inhale the gas. After the contraction, you remove the cap and the administration will stop automatically. The midwife monitors whether you are using the laughing gas correctly. Sometimes women get nauseous while using it. Laughing gas has no negative effects on the baby. The gas can be given by the midwife, you do not need to be referred to the gynaecologist for this.

Laughing gas can in any case be given in the Birth House Utrecht and in the Wilhelmina Children’s Hospital. Depending on availability and room, it is also possible in the Antonius Hospital.

 

Remifentanyl

Remifentanyl is a morphine-like substance that is administered through an IV. By means of a pushbutton you can control the amount you get administered yourself. The pump has been adjusted so that you cannot overdose yourself.  It is a substance which works very quickly, within 1 minute it will make you drowsy and takes the edge off the pain. There is no anaesthesiologist needed to administer it, so it can be given quickly. Remifentanyl is usually administered at the later stages of childbirth as long-term use can cause the drug to become ineffective near the final stage.

With both options of pain relief it is necessary to transfer you to the care of the gynaecologist. Depending on how far along you are with your delivery and also the gynaecologist’s estimation, you will get to discuss what kind of pain relief you prefer.