Pain relief for labour

What pain relief can I get during labour?

Everyone is different when it comes to pain and pain relief, especially during labour. As a result, it is always difficult to know which pain relief option will work best for you. The midwife caring for you during your delivery will always guide you according to their own experience with delivering babies. Below are some options with brief descriptions on how they work and what is involved.

Complementary methods

This involves relatively simple approaches that help calm you and distract you from the pain of labour.

Calm breathing and a soothing massage are often very comforting and reassuring, and can help you relax. This in turn can help minimise your discomfort.

Having your labour in water (eg birthing pool or bath) has also worked for many women during labour.

Other strategies such as aromatherapy, acupuncture and calming music can be used to reduce anxiety, improve your wellbeing and encourage you to keep going.


Entonox is a gas mixture made up of nitrous oxide (‘happy gas’) and oxygen. It is breathed in through a mouthpiece during your contractions. It is simple to use, works quickly and wears off quickly. It may make you dizzy and a little nauseous for a short period of time.

Entonox will not take the pain away completely, but it often helps. It can be used at any time during your labour and will not harm your baby.


Opioids are strong painkillers that are used for moderate to severe pain. Pethidine, morphine and fentanyl are drugs that belong to this group of medication. Opioids are often given by the midwife as an intramuscular injection into your arm or leg. Smaller amounts can be given into an intravenous line in your arm.

These drugs all work in similar ways, but can have different effects on the individual. Their effectiveness in reducing pain during labour is quite variable. Some women feel more relaxed and less worried about the pain. Others feel less in control, which can be a disappointment for some.

Possible side-effects include:

  • Drowsiness
  • Nausea and vomiting. Anti-nausea medication can be given to reduce or prevent this.
  • Delayed stomach emptying, which may be an issue if general anaesthesia is required.
  • Slow down your breathing, occasionally requiring you to have supplemental oxygen via nasal prongs or facemask.
  • They may make your baby slow to take its first breath. An injection of medication to your baby can help reverse this effect.
  • Drowsiness of your baby, which may mean that initially your baby may be slow to feed.

Epidurals and Spinals

Epidurals and spinals are the most effective method of pain relief for labour. Anaesthetists are specially trained doctors that have the unique skills to perform these procedures to make you comfortable during labour or caesarean section.

Epidurals and spinals effectively do the same thing – they ‘numb’ the nerves at their origin in the spinal canal. Often people say that it is an injection into your spinal cord – this is not correct.

A spinal involves a single injection between the bones of your lower back. Once the right space has been found (the space containing spinal fluid surrounding the nerves) a small dose of medication is injected rendering those nerves numb for a period of about 2-3 hours. Spinals have a relatively rapid onset of action – within a few minutes. As there is no tubing (or needle) left behind to ‘top-up’ your anaesthesia, spinals are mainly used for rapid temporary pain relief or for caesarean sections.

 An epidural involves inserting a fine plastic tube via a needle in the back into a space called the epidural space. Pain killing medication (usually a combination of local anaesthetic and an opioid eg fentanyl) is injected through the catheter to bathe the nerves making them numb. The needle is removed and all that is left is the fine plastic tubing that stays taped to your back. You can lie comfortably on this tubing without noticing it or affecting the epidural.

Epidurals effectively numb the nerves at their origin from the spinal cord to provide you with excellent pain relief. Epidurals however are not instant with their relief. It may take half an hour or longer to put the epidural in and get it working properly. Once in however, it can be used for the duration of your labour. Additionally, an epidural can also be used to provide analgesia and anaesthesia for deliveries requiring ventouse (vacuum), forceps or caesarean delivery.

Epidural and spinal anaesthesia have minimal effects on your baby.

For more information about epidurals and spinals, please click here to be taken to our information sheet.