Pain relief and having a baby
You might not need the care of an anaesthetist when you’re carrying and delivering your baby, but it’s good to know what your options are..
General information about anaesthesia and having a baby
Being pregnant and giving birth involves major changes in our bodies. Discomfort or pain during labour is common and some women will require surgery while pregnant.
Can I have anaesthesia when I’m pregnant?
Surgery can be performed during pregnancy and breastfeeding. Your anaesthetist will assess you and tailor your treatment to your individual needs. They’ll also be happy to talk you through the process and answer any questions you have.
How do I manage discomfort during labour?
Your midwife and obstetrician will help you to manage mild and moderate birthing pain. But if you need stronger, longer lasting relief or require a caesarean delivery they will need to ask an anaesthetist to join your birthing team. Anaesthetists are available at major hospitals, but if you’re planning to have your baby at a smaller hospital, you should check with your midwife or GP.
How soon can I breastfeed after having anaesthesia?
You’ll usually be able to have skin-to-skin contact with your baby straight away, and start breastfeeding as soon as you feel ready.
Will I need post-natal pain relief?
You may require pain medication after giving birth. Most pain medication will be OK to take while breastfeeding, but your birthing team will discuss this with you at the time.
Pain relief during labour
Every birth is different, but it’s common and natural to experience some degree of discomfort during labour. Your midwife and obstetrician will help you to manage mild and moderate birthing pain, but if you need stronger, longer lasting relief or require a caesarean delivery, they’ll invite an anaesthetist to join your birthing team.
To help you with your pain when you go into labour, your midwife will usually suggest starting with some simple relaxation techniques such as stretches, massages, and breathing exercises. These may be familiar to you from antenatal classes. They can help you to feel more comfortable and in control of your contractions. If your partner is with you, they can also get involved.
Happy gas (AKA “laughing gas”)
Breathing a mixture of oxygen and nitrous oxide gas (commonly called “happy gas” or “laughing gas“) can help you to control your contractions and feel more relaxed. The gas is generally delivered through a mouthpiece which you can put in and take out at any time to control the flow. You’ll still be fully aware, and able to move and experience sensation.
Stronger pain medication
If you start experiencing more severe discomfort, your obstetrician can give you an opioid-based pain medication such as morphine. This is generally injected into your muscle tissue. Opioids delivered in this way are generally safe to use at any stage of labour. They allow you to stay fully aware and able to experience sensation. They can provide highly effective and almost instant pain relief, but their effects are relatively short lasting.
More sustained pain relief
If the happy gas and morphine aren’t keeping you comfortable enough - or there’s a chance you’ll require a caesarean delivery - your obstetrician may ask an anaesthetist to join your birthing team to provide stronger, longer lasting pain relief such as epidurals.
Epidurals offer the most complete relief from contraction pain. They rapidly numb the lower body, but allow you to be aware during the birth of your baby. They can provide sustained pain relief that can be tailored to your needs to still allow a degree of movement and sensation.
Why would I need an epidural?
If the happy gas and morphine aren’t keeping you comfortable enough - or there’s a chance you’ll require a caesarean delivery – your obstetrician may strongly recommend an epidural. There are also some medical reasons – such as if you’re having twins or have high blood pressure - that make epidurals necessary.
How does the epidural work?
Your anaesthetist will inject local anaesthetic – usually mixed with an opioid-based medication such as fentanyl – into the space around the spinal nerves in your lower back. This blocks the pain signals from contractions and cervical dilation travelling to your brain.
A fine plastic tube known as an “epidural catheter” is threaded through the epidural needle. This needle is then removed, leaving only the catheter, which is taped to your back and can be used to give more pain-relieving medication.
When can I request an epidural?
As a general rule, you can request an epidural at any stage during labour provided there are no medical reasons that would prevent you from having one, and following consultation with the midwife and/or obstetrician. It usually takes between 15 and 30 minutes to insert an epidural. Local anaesthetic is then given through the epidural, with pain relief starting about 10 minutes later.
What if I need a caesarean (‘c-section’)?
If a caesarean delivery is necessary, your anaesthetist can use the epidural to provide anaesthesia, making your body numb below the chest. Because this is a surgical procedure, the anaesthesia will be a lot stronger and your anaesthetist will be with you for the entire time. You’ll usually be awake for the experience, except for those situations requiring general anaesthesia.
As Australasia’s leading authority on anaesthesia, ANZCA provides accessible, evidence-based information designed to help you make informed decisions. This information is a guide only and should not replace information supplied by your anaesthetist.
Our sister colleges have comprehensive information on managing discomfort during labour and after giving birth.