Can paracetamol lengthen your labour?

In March 2015, an undercover midwife wrote about her concerns, regarding the increase in women experiencing longer labours.  She felt that there may be a link between what she described as “the rise and rise of the latent phase of labour”, and the increased use of paracetamol that women are taking as a comfort measure during those early hours.

She identifies her reasons for concern in her article :- Paracetamol and Labour, looking closely at research to suggest that paracetamol can inhibit the production of prostaglandins.

The release of prostaglandins during the early stage of labour is vital, as it helps the cervix to soften, thin and begin to open those first few centimetres, helping women to get into established labour.  It is in fact even more important to have high levels of prostaglandins at this point in the process, than the hormone oxytocin.

The recommendation of taking paracetamol in early labour however has become the norm, and you will read on the majority of pregnancy information websites and hospital literature that this may be taken in early labour.  Most modern maternity wards offer a telephone triage system, so that they can establish which women need to come in straight away, and which women they need to try to encourage to stay at home a bit longer.  The triage midwife will listen and assess the woman by asking a series of questions.  If early labour is established, they will be advised to eat and drink, take some paracetamol and have a bath.  This is obviously suggested for all the right reasons, in order to help women to relax and to provide them with enough pain relief that it will stop them from going to the hospital, or calling a midwife to their homebirth too early.

Whilst it is indeed a great idea for low risk women to remain in their own homes until labour is established, the undercover midwife said in her article, that the risks involved in recommending paracetamol in the latent phase could work against a woman’s physiology, therefore accounting for the huge increase in women experiencing a long latent phase.  The drugs simply “knock off” the production of prostaglandins, and the labour gets longer and longer.

Other risks mentioned in the article include:- damage to the mother’s liver and considerable risks to the baby (ADHD and increased risk of childhood asthma).

When we asked women who had taken paracetamol in labour whether they felt it had helped them, almost all said that it had made no difference at all.

Here are some alternative ideas to help support you in early labour:-

• Sleep/rest  – This is the most important thing you can do in early labour.  Conserve your energy and relax.  Keep the room dark and quiet and stay nice and warm.

• Breathing techniques – In early labour it is important to breath slowly and develop a good calm technique that supports you through each contraction.

• Have a bath– It can be very relaxing to have a bath, but ensure that you stay in a good position by leaning forward or lying on your side.

• Eating and drinking – Nutritious food and drinks keep your energy levels up and you hydrated.

• Moving and positioning – Some positions offer more comfort in labour than others. Women tend to find upright positions most comfortable with the pelvis tilted forward so that the weight of the baby is off the spine.

• Listening to guided relaxation or music – You can prepare a playlist in advance.

• Heat pads/wheat bag/hot water bottle – Perfect for placing on the lower back or under the bump to provide comfort.

• Stand in the shower with the warm water on your back – If you have a shower, this can be a fantastic way of relieving strong sensations in the lower back.

• TENS machine – These can be hired online and used in early labour.

• Birth ball – Opens the pelvis and helps baby into a good position.

• Massage – Birth partners can feel useful when offering to massage.  This can be extremely relaxing which will help with the release of hormones.

• Pressure techniques – Strong pressure on the lower back can help to alleviate discomfort.

• Aromatherapy – During labour, many women find essential oils useful.  The most common being:- lavender, lemon, camomile and clary sage.  They can be used in massage oil, in the bath, in a diffuser or on a piece of cloth placed nearby.