The pain of labour, which is associated with contraction of the uterine muscle and is usually at a maximum at full dilatation of the cervix, is greater if the mother is apprehensive or tense. As in other conditions, diagnosis comes first: is the mother anxious, in pain, or merely sleepless? She will be helped by knowing about labour, and by confidence in herself and those who are helping her. Drugs should be used to support her own management and should not come first: a hypnotic for sleeplessness, perhaps a sedative or tranquilliser for anxiety and an analgesic by injection or inhalation for pain. The specialised techniques of epidural block or regional analgesia will not be discussed. The inhalation gases will be dealt with in a forth-coming article.
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