Pain relief in labour: from breathing to an epidural

Every labour hurts differently, and every woman feels pain differently. There is no “better” or “braver” choice: there is the choice that suits you, on that day. You can change your mind during labour too.

Without medicines

• Movement and position. Walking, rocking, standing or kneeling often ease pain more than lying on your back.
• Breathing. Slow, deep breaths through a contraction help you not to tense up. Practise before the birth.
• Massage. Pressure on the lower back helps many women.
• Warm water. A warm shower or bath relaxes the body, especially in early labour.
• A birth partner. Someone you trust beside you lowers anxiety. Ask your maternity unit in advance whether a partner is allowed in the room.

With medicines

Painkilling injections. Given into a muscle, they work after about 20 minutes and last 2 to 4 hours. They can make you feel sick or sleepy. Given too close to the birth, they can affect your baby’s breathing and first feed, so they are not given when the birth is very close.

Gas and air. Some maternity units offer a gas mixture you breathe yourself through a mouthpiece. It does not take the pain away completely, but it softens it. It can make you a little light-headed.

Epidural. An anaesthetist places a very thin tube in your back and gives medicine that numbs the pain of labour. In most cases it takes the pain away completely.

What to know about an epidural

• Your legs may feel heavy and you may not be able to walk.
• You may need a tube to empty your bladder, as you cannot feel it.
• The pushing stage can take longer, which slightly raises the chance of a doctor helping with ventouse or forceps.
• Rarely it lowers blood pressure, and around 1 in 100 women get a headache afterwards.

“An epidural leaves you with back pain for life.” Many women hear this. Back pain after birth is common in mothers, with or without an epidural, because it comes from pregnancy and carrying a baby. The injection site can be a little sore for a few days.

“A birth with an epidural is not a real birth.” No birth is more real than another. What matters is that the mother feels listened to.

Questions for your maternity unit, before the birth

Not every maternity unit offers every option, and in some an epidural depends on an anaesthetist being free or comes at a cost. Ask in advance:

• is an epidural available, at any hour, and is there a cost
• is there a bath or shower in the birth room
• is a birth partner allowed
• can you move freely during labour

The answers help you make a plan, and change it calmly if you need to. For what happens at each stage, read the stages of labour.

Sources we consulted

• NHS: Pain relief in labour

Written by the mam.al editors as general information. It does not replace advice from your doctor, anaesthetist or midwife. Contains public sector information licensed under the Open Government Licence v3.0.