Managing Labor Pain: What Are Your Options?

Pregnant woman indoors meditating with eyes closed in lotus pose

How painful is labor, really?

Let’s talk about pain. As your due date gets closer, you’re probably wondering: How much is labor going to hurt? There isn’t a single answer. Everyone experiences childbirth differently, but most women will tell you that, Yup, it hurts. The good news is there are lots of tools for managing labor pain, either with medication or without, and you don’t have to pick just one. It’s important to check out all your options and remember you can combine different methods or choose a new one any time. Your doula can help by talking through the pros and cons, and making a pain management plan together.

What’s your pain perspective?

It’s useful to think about labor pain from a few different angles. One approach is about relieving the pain completely, or as much as possible, which usually means medication. Another is more about coping with the pain, not making it disappear. Many drug-free techniques can reduce pain or make it easier to handle. A third option is: both. You might find that coping strategies work up to a certain point, and then it’s time for drugs. Either way, it’s your choice. But even if labor pain gets physically intense, you should never feel unsupported.

A medication situation?

If the first thought that comes to mind when you think of labor pain is “Nope! There are drugs for that”, here are some options to be aware of:

  • Epidural: Epidural is the most common method of labor pain relief and the most effective. A tiny tube inserted in your lower back delivers medication at a level you choose for as long as you need it. It should relieve your pain without making you so numb that you can’t push. You can start an epidural any time during labor, but keep in mind that once the tube is in, you probably won’t be able to walk or move around much.

Epidurals have potential side effects like low blood pressure, which can affect your baby, slightly longer labors, and numbness in your legs. Rarely, some people get an intense headache called a spinal headache after an epidural. Strong medical evidence shows that epidurals don’t increase your risk of having a C-section and that the small amount of medication that reaches the baby isn’t harmful.

  • Spinal & Combined Spinal-Epidural: If you need pain relief like right this second, your doctor might use a spinal block. This shot in your lower back can work faster than an epidural, but only lasts for an hour or two. Combining it with an epidural keeps the pain relief going after the shot wears off.
  • Opioids: If you don’t want an epidural, or your doctor doesn’t recommend one, opioid drugs are another option through a shot or IV. Opioids can take the edge off the pain, but they’re not super effective for labor and often have side effects like nausea, vomiting, and drowsiness. These can make pushing difficult and may also have some effects on your baby after delivery.
  • Nitrous oxide: Nitrous oxide (laughing gas) has been used for decades in the U.K., Australia, Scandinavia, Canada and other countries, but it’s less common the U.S. The gas won’t relieve labor pain completely, but it can be as effective as an opioid with fewer side effects. These can include drowsiness and nausea, but since you inhale the gas through a mask, you decide how much to take, and the effects go away quickly when you stop. There is less research on nitrous oxide than other medications, but it’s considered safe for both women and babies.

Prefer to go au naturel?

If drug-free is more your style, there are lots of pain management options that don’t involve medication:

  • Doula Support: Strong medical evidence links having a doula during labor with lower rates of pain and less need for medication. Doulas are trained in a range of comfort and coping techniques like touch and massage, deep breathing, relaxation, emotional support, labor positions, birth balls, aromatherapy, and more.
  • Labor Positions: Women have always used movement and physical positions to help manage labor pain, and there’s a lot of evidence to back up this approach. Research shows that walking and staying upright, instead of lying down, often means shorter labors and less pain.
  • Hydrotherapy: Does a warm shower or bath relax your aches and pains? It might also work during labor. Hydrotherapy is a risk-free, widely used method for reducing labor pain. There is consistent evidence that getting in a shower or tub lowers pain levels and helps with relaxation. Side note: hydrotherapy is not the same thing as waterbirth where the baby comes out in the tub.
  • Hypnosis: Hypnosis has basically been around forever, and doctors have studied its effects for decades. The idea is to shift your consciousness into a relaxed state where you are receptive to “suggestions.” For childbirth, these might be words or images that create safe, positive feelings about labor. In some cases they might even be able to change how you perceive sensations like pain. Sorry, there’s no guarantee this will happen, and the evidence is limited, but it can still be a helpful technique.

Need more info? Mae’s experts are here to help you understand your pain management options, and put in place the best plan for you.  Visit to build your support team today.

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