Pain management options
Our obstetric anaesthesia team work on the labour ward 24 hours a day, 7 days a week. We aim to provide the best possible care and experience for you and your baby. We closely work with the obstetric and midwifery teams to keep you safe.
Our main role is to provide pain relief in labour and to care for patients in the operating theatre in the labour ward. Alongside other members of the team, we also look after patients who develop complications in labour and take an active role in planning the births of women and pregnant people who have complex pregnancies.
The anaesthetist’s role is to:
- provide epidurals, combined spinal epidural and remifentanil patient-controlled analgesia (PCA) (if appropriate) for labour pain relief
- provide anaesthesia for caesarean section or other procedures performed in obstetric theatres
- support midwifery and obstetric teams in the care of women and pregnant people on the labour ward
- assist in running the labour ward high dependency unit (HDU)
- run a high-risk obstetric anaesthetic clinic for mothers with complex pregnancies, complex medical conditions or any high-risk factors related to anaesthesia
- offer postnatal review in our clinic for women and pregnant people who have had a complex birth due to their medical or surgical background or developed any anaesthetic-related complications
Epidurals
An epidural is the only method of pain relief that can remove almost all sensation during labour. It can only be inserted by an anaesthetist.
An epidural involves inserting a needle into the lower part of your back and using this needle to place a thin plastic tube called an epidural catheter near to the nerves in your spine.
The needle is then removed, and the epidural catheter remains in place so that pain relieving medication can be given through it during your labour.
We use patient-controlled epidural anaesthesia which means that you will have a button which you push to get doses of these painkillers into the epidural.
An epidural that is working well can usually be topped up to provide anaesthesia and pain relief should you need an instrumental birth or caesarean section.
Find out more information about epidurals.
Spinals
Most caesareans are performed with you awake using regional anaesthesia (spinal or epidural top-up).
Some advantages of regional anaesthesia include that you are awake to meet your baby when they arrive, your birth partner can be present, your baby is likely to be born more alert and you will have good pain relief after the operation.
A spinal uses a very fine needle to inject a mixture of painkillers into the fluid which surrounds your spinal cord and the nerves at the bottom of your back.
Find out more information about spinals.
General anaesthetic
Although most caesarean sections are done using regional anaesthesia sometimes general anaesthesia is used.
The most common reasons for this are when there is an urgent need to deliver your baby and there is no time to perform a spinal or epidural top-up. Sometimes regional anaesthesia is not possible due to the medical or surgical background of the pregnant person. You might also choose to have general anaesthetic if you do not consent to regional anaesthesia.
Find out more information about general anaesthesia for caesarean sections.
For more information on pain relief options for labour or anaesthesia for caesarean sections, visit the LabourPains website.