Women may soon be able to use a nasal spray for pain relief during childbirth following successful trials by an Australian midwifery researcher.
The nasal spray analgesic drug, fentanyl, was shown to be just as effective in relieving labour pain and have fewer side effects than pethidine injections, which are commonly used.
Fentanyl nasal spray is commonly used for pain relief in children and in patients being transferred by ambulance.
As a result of the Flinders University and the University of Adelaide study involving 156 women, fentanyl is expected to be offered as an alternative medication in South Australian maternity hospitals this year.
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"Women can self-administer a controlled dose using the nasal spray, under a midwife's supervision, which helps them feel more in control of their pain management and avoids the need for additional intervention and painful injections," said lead researcher Dr Julie Fleet.
Fentanyl resulted in less nausea and sedation, shorter labour, fewer babies admitted to the nursery, fewer breastfeeding difficulties and greater satisfaction, she said.
"Fentanyl administered by the nasal spray doesn't completely eliminate pain - as it can when administered as an epidural, which blocks all sensation - so it is suited to women who still want to be able to feel something," Dr Fleet said.
"It's also good for women who might not be able to have an epidural due to conditions such as pre-eclampsia."
Pethidine and fentanyl are opioids, which cross from the mother to the baby.
But when pethidine is processed by the body it's converted into another active drug and remains in the baby's body for three or more days, potentially causing breathing trouble, drowsiness and irritability.
"Because fentanyl is not converted in the same way and is out of the system within two to seven hours, it has less chance of producing negative effects on the baby."
Dr Fleet is now examining whether the nasal spray will also reduce the need for epidurals.
