Labour pain relief options

Learn about the most effective labour pain relief options that will help you achieve a more comfortable and rewarding birth.

It’s a good idea to research your pain relief options in advance, as this will improve your ability to cope with any discomfort during labour. Make sure that you understand your options and their impact on you, your labour and baby. Antenatal classes teach the breathing and relaxation exercises essential for getting through the contractions, but there are several stronger options available, if the pain becomes unmanageable. During childbirth, panic and tension will make your contractions seem more forceful. Instead of struggling against them, try to breathe through each contraction, allowing your body to do its work. Below are some of the pain relief options that you may be offered during labour:

Labour pain relief options:

1. Getting comfortable

Good positioning, being mobile and upright can often help a woman cope better with labour and labour well. Ask what birthing aids are available for you to use during labour.

2. Alternative pain relief

Some women may decide to use an alternative form of pain relief to help them cope with labour, for example, hypnobirthing, yoga, reflexology or acupuncture. If you plan to do this, ask your care provider what their policy is on alternative forms of pain relief. Water is an excellent form of pain relief: a shower, bath or, if it’s available in your hospital, a birth pool. Water creates a nurturing, calm environment, which promotes the natural release of the hormone oxytocin. Oxytocin is essential for labour/birth to occur. By submerging in the water, you are weightless and can assume positions that make the contractions seems less painful.

3. The TENS machine

A Transcutaneous Electrical Nerve Stimulation (TENS) machine sends electrical impulses through four sticky pads placed at certain points on your skin to block pain messages as they travel through the nerves to your brain. It creates a tingling sensation and promises to release endorphins, the happy hormone which acts as your body’s natural pain relief. TENS machines are really helpful in early labour as well as the later stages. You can control the strength of the current as your contractions become stronger.

The fantastic thing about a TENS machine is that you can buy or rent your own one to use as you are labouring at home. In order for it to work as effectively as possible you must start using it from the very first twinge of labour and you can’t use it near any source of water. Make sure that you are familiar with how your TENS machine works before you go into labour.

4. Gas and air

Entonox or ‘gas and air’ is 50% nitrous oxide and 50% oxygen. Stored in the delivery room, you inhale it through a mouthpiece or a face mask and it accumulates in your blood stream to relieve the intensity of your pain. You can manage it yourself by breathing it when you feel a contraction coming on. It may make you feel nauseated, dizzy or light headed but this will not last for long as it leaves your system very quickly.

5. Pethidine

This is a painkiller that is given as an injection usually into the muscle (intramuscularly). It dulls the pain by acting on the nerve cells in your spine and brain, takes about 20 minutes to work and lasts for up to four hours. It seems to work best for women during the early stages of labour and can help relax them and make them feel a bit sleepy. Pethidine is transferred into breastmilk. It crosses the placenta and can make the baby sleepy. After pethidine, the woman needs to stay on the bed for a couple of hours as she may feel drowsy or unsteady on her feet.

6. Epidural

The epidural is a local anaesthetic that’s injected into your back by an anaesthetist to deaden the nerves between your spine and womb, leaving you numb from the top of your bump down to your toes. You will not be able to mobilise as you will have no feeling from the waist down. You will need to be continuously monitored on the bed and birthing positions are limited. Women with epidural can find it more difficult to push effectively and for this reason may need help by having an instrumental birth.

Before you get your epidural you will need a drip to give you fluids to make sure that your blood pressure does not get low. You will be asked to lie down or curl over to make sure that you are in the correct position for the anaesthetist. Your back will be cleaned with a very cold solution and then you will feel a pinch as a local anaesthetic numbs the area so that you won’t feel the epidural needle. A very thin plastic tube is placed into your back, close to the nerves that carry the pain to the uterus. The epidural drugs are given through this plastic tube and it takes about 15 minutes to work.

Once your epidural is in place, a catheter will be inserted into your bladder to keep it empty and you will not be able to walk around. Common side effects of the epidural include itching – it’s totally normal, so don’t worry. Medication can be given to counteract these effects if needed.

What can you do to help with your labour pains? 

Eat beforehand: At the onset of labour, while you are at home, have something light to eat or drink.
Run a bath: Have a warm bath. This can ease the pain and discomfort, and help you to relax. Ask your maternity hospital if they have a bath or pool you can labour in. 
Keep active: Try to be as mobile as you can, and walk around your own house or garden. This will aid gravity, and, in turn, help the baby’s head to descend. 
Listen to some sounds: Music can help you to relax and can be a diversion in early labour.
Have a back massage: Ask your partner to massage your lower back in circular movements if you are experiencing lower back pain with your contractions. 
Stay focused: Keep your focus on your baby. Remind yourself that labour will end and you will then have the beautiful baby you have been waiting for so long to meet.

Mother of three, Laura Doyle shares her birthing story.

“I had every intention of getting an epidural on my third child, again mainly out of fear that I wouldn’t be strong or capable enough. How wrong I was. All my intentions went out the window when she decided to arrive six minutes after I got to the hospital. A coincidence maybe, but I think not. I stayed at home walking around – gravity for sure helped my body with contracting effectively.

When I was in transition, I instinctively got onto all fours (in my hallway!) and this helped hugely with that I gave birth to her with one push and there was absolutely no intervention then or after. No stitches, no stinging, virtually no pain afterwards. I am so thrilled to have proven to myself and maybe others that you don’t need an epidural to give birth and if you are planning on one, just be completely informed on the pros, cons and side effects.”