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I'm Pregnant
Pain Relief During LabourLabour and Birth

Introduction

On this page, you’ll learn more about pain relief options during labour. Your health care provider and childbirth educator can help you learn what other choices you have to help manage labour pain.

Pain relief options

Wondering about labour pain is normal. It can help to look at the pain of labour as a positive type of pain. Labour pain tells you it’s time to begin bringing your baby into the world.

Along with staying calm and focused, working with your body during labour, and using different positions, there are other ways to relieve pain during labour.

Narcotics

What it is

Pain medicine such as morphine and fentanyl are narcotics. They’re given by injection into a muscle (IM) or into a vein (IV).

Benefits

  • Makes the labour pains feel like they are not as strong.
  • Can be used throughout labour.
  • Some birth centres have pumps so you can control when you want the medicine.

Things to think about

  • May cause you to feel dizzy, nauseated or drowsy.
  • May make your baby drowsy which can affect your baby’s breathing and breastfeeding. Your health care providers will take care of your baby if this happens and help you to breastfeed.

Entonox®

What it is

Entonox® is also known as ‘laughing gas’ or ‘gas and air’. It’s a mixture of 50% nitrous oxide and 50% oxygen. You get the gas by breathing through a face mask or a mouthpiece when you have a contraction.

Benefits

  • Gives some pain relief at any stage in labour.
  • You control how much you get.
  • Takes your mind off the pain and helps you relax.
  • Doesn’t have long-lasting effects on you or your baby.

Things to think about

  • May cause dizziness, nausea, numbness or tingling.
  • Doesn’t stop the pain.
Pregnant person in a hospital gown breathing in Entonox through a mouthpiece.

Epidural

What it is

An epidural (anesthetic) can be given during labour. The epidural blocks the pain in the lower part of your body. The doctor who gives the epidural (anesthesiologist) numbs the skin in your lower back. Once the skin is numb, a needle is inserted between the bones of your spine into a space between the layers of membranes in your spinal column. A thin plastic catheter is threaded through the needle. The needle is then taken out and the catheter is taped in place. A pump delivers the medicine to keep you comfortable throughout your labour.

With an epidural, your blood pressure, your heart rate and your baby’s heart rate will be checked often. Before an epidural, you’ll be given information about the procedure and give consent either verbally or in writing. Your anesthesiologist can answer your questions.

Most pregnant individuals who want an epidural can have one, but there are some medical conditions that can prevent a pregnant individual from having an epidural. There may also be times when one is recommended. If you’re interested in having an epidural in labour for pain control, talk with your health care provider ahead of time.

Pregnant person sitting up on a hospital bed with their back exposed, receiving an epidural from an anesthesiologist. Antiseptic is visible on the pregnant person’s lower back, where the needle is being inserted.
Reproduced with permission from © www.pattiramos.com

Benefits

  • Can give the best pain relief.
  • Can be used throughout labour.
  • Easy to give more medicine when needed.
  • Pain relief is quick, and begins within 5–10 minutes, then usually fully effective by 20 minutes.
  • Can let you rest so that you have strength to push.
  • Some pregnant individuals are able to push better with an epidural since their pain has been relieved, but they can still feel the pressure. The amount of medicine can also be adjusted so that you can feel enough to know when to push.
  • Can give pain relief during back labour and during interventions such as vacuum or forceps for an assisted birth.
  • Can be used when other pain methods to manage pain haven’t worked.
  • If you need a caesarean birth you may be able to be awake.

Things to think about

  • It may slow or stop labour if given before you’re in active labour. If contractions slow down, you may be given synthetic oxytocin to stimulate labour.
  • You must have an IV started before you’re given the epidural as it may lower your blood pressure, which could slow your baby’s heart rate for a short time.
  • You may have trouble passing urine and may need a catheter in your bladder during labour to drain your urine.
  • You may not feel the urge to push and need forceps or a vacuum to assist with the birth.
  • You may have to stay in bed because your legs may feel weak. You may be able to get up to go to the bathroom with the help of your health care provider.
  • You may shiver or feel itchy.
  • You may develop a mild fever during labour. Your health care provider will monitor this if it happens.
  • You may have a headache after the epidural wears off. This can be treated.
  • You may feel bruised at the site of the epidural. This usually goes away within a week.
  • There is a very, very small chance that you can have breathing problems, infection, nerve damage or paralysis.

Pushing with an epidural

  • Once your baby is low enough, most pregnant individuals who’ve had epidurals can still feel some rectal pressure—this will help you to know when to push.
  • A pregnant individual with an epidural can also put their hands on their abdomen and feel their uterus tighten up—this will also signal you to push.
  • If you do not have an urge to push, many health care providers will give you more time before starting active pushing. This will help you keep up your energy as pushing without an urge to do so can be very tiring.
  • The amount of medicine can also be adjusted by your health care providers so that you can feel enough of the contraction to know when to push.
  • Your health care providers will also let you know when your contractions are happening and tell you when to push.

Transcutaneous Electrical Nerve Stimulation (TENS)

What it is

TENS is given through electrodes that are placed on your skin. A mild electric current mixes up the pain messages to your brain so you feel less pain.

Benefits

  • May relieve pain in early labour.
  • You control how strong the current is.
  • Helps take your mind off the pain.

Things to think about

  • Works most effectively if you start using TENS in early labour, otherwise it won’t work as well in active labour. It works best if you replace the batteries every 4–6 hours.
  • Can’t be used in the bathtub or shower.
  • You’ll have to rent or buy a TENS machine and take it with you—most birth centres do not have them.
Pregnant person sitting on a hospital bed, holding a controller for the TENS system in their hand. Person has electrodes placed on their lower back, which is exposed.