Pain Relief Options in Labour: What They Do, What They Don’t, & What You Should Know
Introduction
Birth is intense, period. It’s powerful, and for many, it’s painful. Not just a little bit painful, but earth shattering, bone breaking pain that can feel all consuming. Yet for some, whether because of natural predisposition or because they’ve practiced techniques that reshape how they experience labour, birth can actually feel pleasurable rather than painful.
No matter how a woman perceives it, most would agree that birth is powerful and unlike anything else, perhaps the most unique experience a woman can have.
When the topic of pain in birth comes up, many women quickly ask, “When can I get an epidural?” because they would rather not experience that level of intensity at all. Others approach labour with the mindset of “I’ll see how far I can go before asking for one.” And then there are those who begin labour determined to avoid an epidural altogether, either because they want to experience the full spectrum of sensations, benefit from natural endorphins and oxytocin, or avoid exposing their baby to medication.
Whether you are team epidural or team no epidural, the truth is this: the choice is 100% yours. You are not weak for choosing pain relief if that feels best for you and your baby. Only you know, deep down, what you need.
In this article, we will explore the different pain relief options available, how they work, their limitations, and what to consider when making your decision. My hope is that this information helps you feel prepared, empowered, and confident, whether you choose an epidural, skip it entirely, or take a wait and see approach once labour begins.
The Nature of Labour Pain
Pain is pain, but not all pain is the same. As a nurse, when I assess a patient’s pain, I always ask them to describe it. Pain might be sharp, like a stabbing acute sensation, or dull, like a chronic, persistent, throbbing ache. It can stay local or radiate to another area.
We also ask patients to rate their pain on a scale from 0 to 10, with zero being no pain and 10 being the worst pain they’ve ever felt. What’s important to remember is that pain is highly individual. The same broken finger might feel like a 2 out of 10 for one person and an 8 out of 10 for another. So if you hear someone say, “I didn’t need an epidural, it wasn’t that bad,” and you find yourself experiencing labour pain as the most intense pain you’ve ever felt, that doesn’t make you weaker. It simply means your body truly perceived it that way.
Pain is not pointless. It is a messenger. It is there to tell us something. Labour pain is unique in that sense; it is a productive, purposeful pain, directly linked to uterine contractions and cervical changes that help your baby make their way into the world.
It is also different because it usually isn’t continuous. Most contractions are intermittent, with breaks in between where the pain fades and you return to baseline. In those breaks, you can breathe normally, talk, move, and even eat or drink. This is especially true in the early stages of labour, when contractions tend to be irregular and spaced apart.
As labour intensifies, your body’s amazing design steps in. Endorphins, your body’s natural pain relievers, are released to help you cope, creating a built-in support system to guide you through. This, along with the breaks, and keeping in mind that the pain is temporary and is what’s bringing you closer to meeting your baby, can sometimes be enough to get you through. But don’t worry if that’s not the case for you. There are many factors involved, and the best thing you can do to prepare is to educate yourself, just like you’re doing now.
Non-Medical and Holistic Approaches
Before we look at medical options, it’s worth knowing that there are many non-medical ways to support your body and manage pain naturally. These approaches can make a huge difference, especially when used early and consistently.
Movement and Positioning
Changing positions, swaying, walking, and using upright postures help your baby move down and apply pressure on the cervix, which can shorten labour and reduce pain perception. Gravity is your friend.
Water Immersion
A warm shower, bath, or birthing pool can work wonders. Warm water relaxes muscles, eases tension, and helps release endorphins. Many women find contractions far more manageable once they get into the water. However, getting into the water too early can actually stall progress, so try to delay this one. Alternatively, if you sense things have slowed down once you got into the water, you can get out, move around, and try different positions to help pick things up again.
Breathing and Relaxation Techniques
Slow, mindful breathing and relaxation techniques such as hypnobirthing, meditation, or guided imagery help calm the nervous system. When you breathe deeply, you signal to your body that you’re safe, which lowers adrenaline and allows oxytocin (the “labour hormone”) to flow.
Hands-On Support
Massage, counter pressure on the lower back, and acupressure points can all help during contractions. Having a partner, doula, or nurse provide this kind of touch can make you feel grounded, supported, and less overwhelmed.
The Environment
Your surroundings play a big role in how your body perceives pain. That’s why your choice of where to give birth is so personal. Some women view the hospital as the safest place they can be, and their bodies sense that. For others, hospitals feel clinical and unfamiliar, so labouring and birthing at home feels more natural and safe.
Things like dim lighting, calm music, soft voices, and familiar scents can make a hospital or birth centre feel more like a safe cocoon, which helps your hormones do their job.
These methods may not remove pain completely, but they can help you feel more in control, more relaxed, and more connected to your body, which can, in turn, reduce the need for stronger interventions.
Medical Pain Relief Options
Sometimes, natural methods aren’t enough, or labour takes a turn that makes medical pain relief a good option, and there’s absolutely no shame in that. Here are the most common forms used in hospitals:
1. Nitrous Oxide (Laughing Gas)
This is an inhaled gas you breathe through a mask during contractions. It acts quickly and leaves the body just as fast. It doesn’t eliminate pain completely but takes the edge off and helps reduce anxiety. It’s also considered safe for baby, as it doesn’t build up in the bloodstream.
2. Narcotics / Opioids (for example, Morphine or Fentanyl)
These medications can be given by injection or IV. They can dull pain and help you rest between contractions. However, they can cause drowsiness, nausea, or dizziness, and since they cross the placenta, they can make your baby a bit sleepy after birth, sometimes affecting early breastfeeding.
3. Epidural Anaesthesia
The epidural is the most effective form of pain relief in labour. It provides continuous medication through a small catheter placed in your lower back. The medication flows steadily throughout labour and can be adjusted as needed by the anaesthesiologist.
The epidural works by combining two types of medications:
A local anaesthetic (such as bupivacaine or ropivacaine), which numbs the nerves that carry pain signals from the lower body.
A small dose of opioid (usually fentanyl or sufentanil), which enhances the pain relief and allows the anaesthetic dose to stay lower, helping you retain some mobility and sensation.
This combination provides profound relief from contraction pain while keeping you awake and alert. Many women find that once the epidural is in place, they can rest, relax, or even nap as their labour progresses.
That said, there are a few considerations. Epidurals usually involve more monitoring, limited mobility, and sometimes a longer pushing stage. There’s also a small risk of your blood pressure dropping which in turn can affect your baby’s heart rate. This is something nurses and anaesthesiologists closely monitor for and intervene as needed. You’ll also likely require a bladder catheter since you won’t feel the urge to pee.
Epidurals can be a wonderful option, especially in long or complicated labours, but it’s worth knowing both the benefits and the trade-offs so you can make an informed choice that feels right for you.
What Pain Relief Does Not Do
Pain relief, whether medical or natural, doesn’t eliminate the emotional intensity of birth. You may still feel pressure, exhaustion, fear, or even moments of overwhelm. It also doesn’t guarantee that your birth will go according to plan, interventions may still be needed, and that’s okay.
Most importantly, no form of pain relief replaces the need for emotional and physical support. A calm environment, a supportive partner, and a compassionate care team all play a huge role in how you experience your birth.
Choosing What’s Right for You
Pain relief is not an all or nothing choice. Many women combine approaches, starting with movement and water, adding nitrous oxide or IV medication later, or choosing an epidural when it feels right.
Plans can also change as labour unfolds, and that’s completely normal. The key is being informed so you can make choices that align with your values, your comfort, and your baby’s well-being.
Here are a few good questions to ask your care provider ahead of time:
What pain relief options are available at my hospital or birth centre?
What are the side effects, and how are they managed?
How will these choices affect my mobility, pushing, and immediate bonding with my baby?
Can I combine methods or try one before moving to another?
If I choose home or birth centre but decide I want an epidural, what is the transfer process to a hospital like?
Empowered birth is not about avoiding all interventions, it’s about knowing your options and making choices that feel right for you in the moment.
Conclusion
There is no single right way to give birth, and every choice, from breathing techniques to epidural, can be valid and empowering if it’s made from a place of knowledge and self-trust.
Whatever you choose, remember this: you are not just managing pain. You are giving birth to your baby. You deserve comfort, respect, and support every step of the way.
