Almost 70,000 fewer women are given pain relief during childbirth compared to a decade ago, NHS figures show
- Extra 68,970 women delivered child without drugs this year compared to 2009
- Mothers-to-be often offered anaesthetic or pain-killing injections to ease agony
- Experts told MailOnline they were baffled as to why the change had occurred
The number of women not given pain relief during childbirth has plummeted by 70,000 in a decade, figures show.
Mothers-to-be are often offered anaesthetic, pain-killing injections or gas and air to ease the agony of giving birth.
But a NHS Digital report revealed there was a six per cent drop in women who went into labour without these drugs between 2008/08 and 2018/19.
The number of women who were given painkillers during childbirth in 2018/19 are split into different age categories and compared to 2008/9
It means an extra 68,970 women in England and Wales delivered their child without pain medication in 2018/19, compared to 10 years ago.
Experts told MailOnline they were baffled as to why the change had occurred – and the lack of detail makes it hard to draw any firm conclusions.
It was suggested that it could be down to an increase in midwives providing care for women throughout their pregnancy, meaning their birth goes more smoothly.
Elizabeth Duff, senior policy adviser at the National Childbirth Trust, said: ‘It’s a good idea for women to be aware of all the options they have to try to manage pain in labour.
‘These range from painkilling drugs to moving into different positions, breathing techniques or using a birthing pool.
‘Being informed can make them feel more in control, especially if the unexpected happens.’
Gas and air is a mixture of oxygen and nitrous oxide is given through a mask or mouthpiece which women hold themselves.
The gas takes about 15 to 20 seconds to work, so they are advised to breathe it in just as a contraction begins. Many women like it because it’s easy to use and they feel in control.
But if this method does not ease the pain enough, mothers-to-be will either be offered anaesthetic or pethidine injections to numb their nerves.
The NHS Maternity Statistics report also revealed the number of teenage mothers had halved in a decade – falling from 42,209 to 16,956 since 2009
The NHS Maternity Statistics report also revealed the number of teenage mothers had halved in a decade – from 42,209 to 16,956 since 2009.
Better sex education, access to contraception and a trend of women choosing to get pregnant later in life may explain the figure falling.
Deliveries for women in their thirties has increased by seven per cent, climbing from 279,206 to 298,590 in the same time.
The number of children being born is also at its lowest level in a decade, falling 7.5 per cent from 652,638 to 603,766 in the last 10 years.
The analysis looked at alcohol intake among mothers-to-be at their first appointment after conceiving.
Alcohol status was reported in only 327,495 (60 per cent) of births, but 97 per cent of those women said they were currently consuming no alcohol.
Of those who were drinking, 6,613 (two per cent) consumed between one and four units a week, while 1,512 (0.5 per cent) drank between five and nine.
Data showed 512 (0.2 per cent) mothers reported consuming more than 10 units – the equivalent of a 750ml bottle of wine.
And 495 women told their doctor they were consuming upwards of 14 units a week, or five large glasses of wine.
WHAT PAINKILLERS ARE USED DURING CHILDBIRTH?
Gas and air (Entonox)
This is a mixture of oxygen and nitrous oxide gas. Gas and air won’t remove all the pain, but it can help reduce it and make it more bearable.
Many women like it because it’s easy to use and they control it themselves.
You breathe in the gas and air through a mask or mouthpiece, which you hold yourself.
The gas takes about 15-20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.
There are no harmful side effects for you or the baby, but it can make you feel light-headed
Some women find that it makes them feel sick, sleepy or unable to concentrate – if this happens, you can stop using it.
If gas and air doesn’t give you enough pain relief, you can ask for a painkilling injection as well.
Pethidine injections in labour
This is an injection of the drug pethidine into your thigh or buttock to relieve pain.
It can also help you to relax. Sometimes, less commonly, a drug called diamorphine is used.
It takes about 20 minutes to work after the injection. The effects last between two and four hours, so wouldn’t be recommended if you’re getting close to the pushing (second) stage of labour.
There are some side effects to be aware of:
- it can make some women feel woozy, sick and forgetful
- if pethidine or diamorphine are given too close to the time of delivery, they may affect the baby’s breathing – if this happens, another drug to reverse the effect will be given
- the drugs can interfere with the baby’s first feed
An epidural is a special type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It shouldn’t make you sick or drowsy.
For most women, an epidural gives complete pain relief. It can be helpful for women who are having a long or particularly painful labour.
An anaesthetist is the only person who can give an epidural, so it won’t be available at home.
If you think you might want one, check whether anaesthetists are always available at your hospital.
How much you can move your legs after en epidural depends on the local anaesthetic used. Some units offer ‘mobile’ epidurals, which means you can walk around.
However, this also requires the baby’s heart rate to be monitored remotely (by telemetry) and many units don’t have the equipment to do this.
Ask your midwife if mobile epidural is available in your local unit.
An epidural can provide very good pain relief, but it’s not always 100 per cent effective in labour.
The Obstetric Anaesthetists Association estimates that one in eight women who have an epidural during labour need to use other methods of pain relief.
How does an epidural work?
To have an epidural:
- a drip will run fluid through a needle into a vein in your arm
- while you lie on your side or sit up in a curled position, an anaesthetist will clean your back with antiseptic, numb a small area with some local anaesthetic, and then introduce a needle into your back
- a very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the uterus. Drugs (usually a mixture of local anaesthetic and opioid) are administered through this tube. It takes about 10 minutes to set up the epidural, and another 10-15 minutes for it to work. It doesn’t always work perfectly at first and may need adjusting
- the epidural can be topped up by your midwife, or you may be able to top up the epidural yourself through a machine
- your contractions and the baby’s heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby’s head
Side effects of epidurals in labour
There are some side effects to be aware of:
- An epidural may make your legs feel heavy, depending on the local anaesthetic used.
- Your blood pressure can drop (hypotension), but this is rare because the fluid given through the drip in your arm helps to maintain good blood pressure.
- Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push.
- You may find it difficult to pee as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.
- About one in 100 women gets a headache after an epidural. If this happens, it can be treated.
- Your back might be a bit sore for a day or two, but epidurals don’t cause long-term backache.
- About one in 2,000 women feels tingles or pins and needles down one leg after having a baby. This is more likely to be the result of childbirth itself rather than the epidural. You’ll be advised by the doctor or midwife when you can get out of bed.
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