Pain relief and birthing aids

Childbirth is a unique experience, but is always accompanied by pain. Contractions exert pressure on the body in varying degrees, dependent on the course of the birth and also on individual sensitivity to pain.

There are various ways in which excessive pain can be alleviated. A medicinal painkiller can often be of help in the case of excessive cramping. Another option is peridural anaesthesia (PDA). The use of additional aids, such as oils, Bach flowers, acupuncture and homeopathy can alleviate tension in a natural way. Some methods can already be employed at a very early stage of contractions, while others can only be used when it is clear that contractions have begun in earnest.

In addition, a sound breathing technique, movement, massage or a bath can help you to relax and can alleviate labour pains. Such exercises can generally be learned in birth preparation courses.

Under normal circumstances, you are free to decide in which way you would like to handle the pain you feel. Anaesthetists and midwives will offer you support and advice so that you can determine the best method for your situation.

Anaesthesia - PDA

Local anaesthesia or analgesia is used for stopping or easing pain in larger areas of the body while conscious. In obstetrics, these are the so-called peridural or spinal anaesthesia.
The lower back is first numbed, and then a very thin plastic tube with peridural anaesthesia (PDA) is inserted between two vertebrae into the meninges (see illustration). Medicine can be passed through this tube for local anaesthesia and analgesia. This medicine flows around the nerves that run from the uterus to the spinal cord and thus numb labour pains during birth.

An especially fine needle with spinal anaesthesia is pushed between the vertebrae through the meninges (see illustration). This way, medicine for anaesthesia can be injected directly into the liquid which surrounds the spinal cord. Both methods can be used with spontaneous deliveries as well as caesareans. 

 

Remifentanil - PCA

One of the latest methods for pain relief during childbirth is Remifentanil PCA. With this method, the mother-to-be can administer the medication – an extremely short, effective and highly potent pain reliever (Remifentanil = Ultiva™) – herself via a drip using an analgesia pump. If a woman wishes to use this form of pain relief during childbirth, the small, handy and portable device can be connected in just a few minutes. When the button is pressed, the pain reliever is administered via infusion so that it immediately enters the bloodstream and begins to take effect. It takes effect and is degraded very quickly in the body, which is reassuring for both mother and child.

The medication involved, Remifentanil (Ultiva®), is used very frequently as a form of anaesthesia. It has also been successfully utilised in the field of obstetrics for several years. The manufacturer has not yet applied for official approval for the use of this drug in obstetrics (“off-label use”). Due to the positive experiences made in many Swiss and international hospitals, these methods are offered in the hospitals Hirslanden Klinik Aarau, Klinik Hirslanden, Klinik Im Park, Klinik Stephanshorn and Salem-Spital.

 

Obstetric gel

Obstetric gels can provide some welcome relief for women in labour.

Obstetric gels reduce friction, thereby making the birth easier, shorter and less traumatic. The gel forms an organic lubricating film in the birth canal that facilitates the baby’s passage.

This can shorten the active labour stage by around 30% and reduces the risk of perineal damage by more than half. So overall the birth is easier, shorter and gentler for both mother and child.

Obstetric gel can generally be used for all vaginal births. One such gel is called Dianatal® and it is also particularly suitable for water births.