Pain Relief Options in Labour: What Every Expectant Mother Should Know

Author: Dr Janefrances Ugochi Ozoilo, MBBS, FMCPH, MSc(PH), PMP

Medical Reviewer: Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc(PH)

Highlights

• Labour pain is real and intense, so it’s okay to want pain relief: you deserve comfort and safety.
  
  
• Knowing your pain relief options early helps you make confident, informed choices during labour.
  
  
• Non-medical methods like breathing, massage, and water immersion can ease pain naturally.
  
  
• Medical options such as epidurals and Entonox provide effective pain relief under supervision.
  
  
• Your hospital’s facilities, available staff, and personal preferences will guide your best choice.
  
  
• Discuss your options with your doctor early so you’re prepared for a safe, smooth delivery.

Why Pain Relief Matters During Labour

Feeling nervous about childbirth is common, especially for new mothers. The pain can be strong, and it is okay to want pain relief. You deserve to feel safe and comfortable. Learning about your options and talking with your doctor can help ease your fears and boost your confidence during labour.

In 1981, a research team in Canada measured labour pain. They used a tool called the McGill Pain Questionnaire to ask 141 women who had delivered babies to describe labour pain using simple words like pounding, stabbing, sharp, cramping, etc. By the time all scores were added, the research team discovered that labour pain ranked very high compared to other types of pain. This explains why pain relief during labour is necessary and the need to prepare for it. They also found out that even women who had prepared for the pains of labour by taking classes eventually asked for an epidural as labour grew more intense [1]. 

Here are 6 reasons why you need to prepare for labour pain:

• It enables you to make choices regarding the type of pain relief in advance.
• Your partner will know when and how to help you.
• It will lessen your fear and anxiety.
• Stress hormones such as adrenaline and cortisol are reduced with good labour pain relief.
• The labour process is exhausting. With pain relief, you can rest in between and push only when necessary.
• It ensures safer and smoother care during labour [1–3].

Non-Medical Pain Relief Methods

What are the non-medical pain relief methods? These are ways in which your body can cope with labour pain without medication. Let us discuss some of these methods.

• Continuous support during labour using a doula

A doula is a person who usually does not have formal training in childbirth. They are hired to give personal support to a woman during labour. Think of a doula as a birth companion who helps you breathe, find comfortable positions, and stay calm. They will not perform medical tasks but can make labour easier. Research shows that continuous support can shorten labour and improve outcomes. If the hospital allows, a partner, sister, mother, or friend can also be a doula. They can be very helpful [4].

• Breathing exercises and relaxation techniques

It has been shown that joining classes for pregnant women that teach breathing and relaxation can help you feel stronger during labour. This feeling of control can boost your confidence [5]. 

• Massage 

This is an old method where firm pressure and gentle strokes are used during labour contractions. It helps reduce pain and anxiety for pregnant women and makes the birth experience better[6].

• Dancing and listening to music: 

Dancing and listening to music can help ease pain and reduce fear, especially for women having their first baby [7]. 

• Aromatherapy

Aromatherapy is the use of gentle scents such as lavender and rose oils in diluted forms to help mothers cope with the pain and anxiety of labour. Keep the room airy to prevent feeling sick from the smells

• Labouring in a bath or pool

Starting labour in water can help reduce the need for medicines like an epidural. It might also make labour shorter. This method of pain relief is called “water immersion”.

• Hypnotherapy

Hypnotherapy is a state where you focus deeply and pay close attention. A trained hypnotist helps guide you. During labour, a hypnotist helps you breathe calmly and relax. This makes your body feel safer. When you are less afraid, your muscles relax, and your brain releases more endorphins and less adrenaline, making contractions easier. It doesn't remove the pain but changes how you feel it and helps you stay in control.

Medical Pain Relief Options

Medical pain relief options involve the use of drugs. These medications ease pain but require regular monitoring of both the mother and baby.

• Epidurals

Epidurals are often used to ease pain during childbirth, where they are available. A small tube is placed in your lower back to give you small amounts of pain medicine. This medicine, usually a mix of bupivacaine and fentanyl, helps numb the pain but keeps you awake so you can talk to your caregivers. Your blood pressure and the baby's heart rate will be checked regularly during this time. Overall, it is generally seen as a safe option [8].

• Entonox

Entonox is a brand name and a mixture of gas and air (nitrous oxide and oxygen) that is usually self-applied. You inhale it through a mask during contractions to get pain relief while staying calm. It also wears off quickly. 

• Opioids

These opioids include pethidine, fentanyl and morphine. They are given through injections into the muscle or veins. They act by briefly numbing the sensation of pain. They do not act as strongly as an Epidural or Entonox [8].

• Pudendal Nerve Block

During the pushing stage, your doctor may put numbing medicine on or into the skin between the vagina and the anus so you do not feel pain if a small cut, stitches, or an assisted birth is needed. Common numbing medicines are lidocaine and ropivacaine. They work quickly, affect only that area, and wear off after the procedure.

• Local Anaesthetic Infiltration

After delivery, there may be a need to repair any tears that were between the vagina and the anus. Medications such as lidocaine spray or lidocaine injections are usually used to numb any pain you may feel during the stitching procedure. Ropivacaine can also be used for this [8]. 

Are Pain Relief Methods Safe for the Mother and Baby?

Talk early

Tell your doctor about any allergies you have, health conditions, and any medicines you take. Discussing pain relief options during labour with your doctor is an important step, especially for first-time mothers who may be burdened with fear and anxiety. Your doctor will guide your choice depending on the benefits and side effects considered. Let us discuss these benefits and side effects.

Non-Medical Pain Relief Methods

Non-medical pain relief methods are generally safe and effective.

• Continuous support using a doula often shortens labour and can reduce the need for pain medicine.
• Breathing and relaxation exercises help you feel in control and lower anxiety.
• Gentle massages on the lower back can ease pain. Stop if it hurts and avoid too much pressure because it can cause soreness.
• Music and light movement can calm you and ease pain. Wear safe footwear and stop if you feel dizzy.
• With aromatherapy, use only well-diluted oils. Never swallow them. If you have allergies or asthma, ask your doctor first.
• Warm-water immersion should be done under your doctor’s guidance. Water should be comfortably warm. Mother and baby need regular checks.

Medical Pain Relief Methods

• Epidurals are very effective for pain relief while you stay awake. However, it requires monitoring. The side effects may include low blood pressure, severe headache, fever, and a higher chance of assisted vaginal delivery. Sometimes a spinal cord injury may occur, but this is very rare.
• You breathe Entonox yourself during contractions. It works fast and wears off quickly. You may have drowsiness, dizziness, nausea or vomiting.
• Opioids give short-term relief. They can cause drowsiness, nausea, or vomiting and may slow breathing in the mother and baby. 
• Pudendal nerve block is excellent for local pain control. Your baby is usually not affected, and side effects are rare.
• Numbing of the area between the vagina and anus is effective for the repair of tears. If used before delivery, it can affect your baby.

How to Choose the Best Pain Relief Option

Choosing the best pain relief should be guided by certain factors. These factors include;

• Stage of Labour

In early labour, options like doulas, breathing, massage, moving around, warm water, and music can help you relax. During the latter stages of labour (active phase of labour), epidurals give steady pain relief and let you rest. For fast labour, Entonox will give a quick pain relief that wears off quickly. However, if your labour is advanced, there might not be time for an epidural and opioids given close to your delivery can make you and your baby sleepy. Giving an epidural early can make it hard to walk or change positions during labour.

• Options available at the hospital you choose

You may need to consider the options available in the hospital you have chosen to have your baby. Some hospitals may have few options available, and this can limit the choices you make.

• Availability of Skilled Health Workers

Pain relief options depend on the staff available when you arrive. Midwives offer non-drug methods and Entonox. Doctors can give injections and pudendal blocks. Epidurals need anaesthetists and monitoring. Staff availability changes with shifts, so ask about 24/7 service and timing. Smaller hospitals might have delays, so have a backup plan. The safest choice is what a trained team can provide where you are.

• Personal Choice

Pick pain relief that matches your needs. If you want to stay awake and move around, try comfort methods or Entonox. If you need strong pain relief, an epidural might be best. Remember, labour can change fast, so be ready to adjust. Some options need monitors or drips and might limit walking.

• Safety

Tell your care team about any allergies, bleeding problems, infections, and medicines you take. This helps them choose safe pain relief for you. An epidural gives strong pain relief without affecting the baby. But, if you have certain conditions like using blood thinners or having low platelets, epidurals may not be safe. Opioid injections can cause nausea and drowsiness. If given close to birth, they might briefly affect the baby's breathing.

Conclusion

Talk to your doctor about pain relief during labour to ease any worries. Be open to changes because your choice depends on how labour goes, what the hospital offers, your health, and what you want. It is a good idea to have both a main plan and a backup plan. Tell your doctor what is most important to you during labour. For instance, would you like to be able to move around or use pain relief? Also, make sure to ask about the availability of staff. Does the hospital provide 24-hour service? Plans can change, but the main goal is a safe birth for you and your baby.

References

[1]      Melzack R, Taenzar P, Feldman P. Labour is still painful after prepared childbirth training. Canadian Medical Association Journal; 125: 357–363. Available from: https://pubmed.ncbi.nlm.nih.gov/7272887/

[2]      Neumark J, Hammerle A, Biegelmayer C. Effects of Epidural Analgesia on Plasma Catecholamines and Cortisol in Parturition. Acta Anaesthesiol Scand 1985; 29: 555–559. Available from: https://pubmed.ncbi.nlm.nih.gov/4060996/

[3]      Raynes-Greenow C, Nassar N, Torvaldsen S, et al. Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet. BMC Pregnancy Childbirth 2010; 10: 15. Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-15

[4]      Campbell D, Lake M, Falk M, et al. A Randomized Control Trial of Continuous Support in Labor by a Lay Doula. Journal of Obstetric, Gynecologic & Neonatal Nursing 2006; 35: 456–464. Available from: https://pubmed.ncbi.nlm.nih.gov/16881989/

[5]      Leutenegger V, Grylka-Baeschlin S, Wieber F, et al. The effectiveness of skilled breathing and relaxation techniques during antenatal education on maternal and neonatal outcomes: a systematic review. BMC Pregnancy Childbirth 2022; 22: 856. Available from: https://pubmed.ncbi.nlm.nih.gov/36402944/

[6]      Chang M, Wang S, Chen C. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. Journal of Advanced Nursing 2002; 38: 68–73. Available from: https://pubmed.ncbi.nlm.nih.gov/11895532/

[7]      Gönenç M, Dikmen H. Effects of Dance and Music on Pain and Fear During Childbirth. Journal of Obstetric, Gynecologic & Neonatal Nursing 2020; 49: 144–153. Available from: https://pubmed.ncbi.nlm.nih.gov/32057687/

[8]      ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia. Obstetrics & Gynecology 2019; 133: e208–e225. Available from: https://pubmed.ncbi.nlm.nih.gov/30801474/

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published October 20, 2025