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Here Comes Baby: Managing Labor Pain


A guide to natural and medical pain relief during childbirth


Virtually all women worry about how they will cope with the pain of labor and delivery. Childbirth is different for everyone. So no one can predict how you will feel. The amount of pain a woman feels during labor depends partly on the size and position of her baby, the size of her pelvis, her emotions, the strength of the contractions, and her outlook.

Some women do fine with natural methods of pain relief alone. Many women blend natural methods with medications that relieve pain. Building a positive outlook on childbirth and managing fear may also help some women cope with the pain. It is important to realize that labor pain is not like pain due to illness or injury. Instead, it is caused by contractions of the uterus that are pushing your baby down and out of the birth canal. In other words, labor pain has a purpose.

Try the following to help you feel positive about childbirth:

  • Take a childbirth class. Call the doctor, midwife, hospital, or birthing center for class information.
  • Get information from your doctor or midwife. Write down your questions and talk about them at your regular visits.
  • Share your fears and emotions with friends, family and your partner.


Natural Methods of Pain Relief

Many natural methods help women to relax and make pain more manageable. Things women do to ease the pain include:

  • Trying breathing and relaxation techniques
  • Taking warm showers or baths
  • Getting massages
  • Using heat and cold, such as heat on lower back and cold washcloth on forehead
  • Having the supportive care of a loved one, nurse, or doula
  • Finding comfortable positions while in labor (stand, crouch, sit, walk, etc.)
  • Using a labor ball
  • Listening to music


Water and childbirth

More and more women in the United States are using water to find comfort during labor. This is called hydrotherapy. Laboring in a tub of warm water helps women feel physically supported, and keeps them warm and relaxed. Plus, it is easier for laboring women to move and find comfortable positions in the water.

In waterbirthing, a woman remains in the water for delivery. The American Academy of Pediatrics has expressed concerns about delivering in water because of a lack of studies showing its safety and because of the rare but reported chance of complications. Ask your doctor or midwife if you want to know more about waterbirthing.

Medical Methods of Pain Relief

While you're in labor, your doctor, midwife, or nurse should ask if you need pain relief. It is her job to help you decide what option is best for you. Nowadays women in labor have many pain relief options that work well and pose small risks when given by a trained and experienced doctor. Doctors also can use different methods for pain relief at different stages of labor. Still, not all options are available at every hospital and birthing center. Plus your health history, allergies, and any problems with your pregnancy will make some methods better than others.

Methods of relieving pain commonly used for labor are described in the chart below. Keep in mind that rare, but serious complications sometimes occur. Also, most medicines used to manage pain during labor pass freely into the placenta. Ask your doctor how pain relief methods might affect your baby or your ability to breastfeed after delivery.


Method How it can help Some disadvantages
Opioids (OH-pee-oids) – also called narcotics, are medicines given through a tube inserted in a vein or by injecting the medicine into a muscle. Sometimes, opioids also are given with epidural or spinal blocks. Opioids can make the pain bearable, and don't affect your ability to push. After getting this kind of pain relief, you can still get an epidural or spinal block later.
  • Opioids don't get rid of all the pain, and they are short-acting.
  • They can make you feel sleepy and drowsy.
  • They can cause nausea and vomiting.
  • They can make you feel very itchy.
  • Opioids cannot be given right before delivery because they may slow the baby's breathing and heart rate at birth.
Epidural and spinal blocks – An epidural involves placing a tube (catheter) into the lower back, into a small space below the spinal cord. Small doses of medicine can be given through the tube as needed throughout labor. With a spinal block, a small dose of medicine is given as a shot into the spinal fluid in the lower back. Spinal blocks usually are given only once during labor. Epidural and spinal blocks allow most women to be awake and alert with very little pain during labor and childbirth. With epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness you feel can be adjusted throughout your labor. With spinal block, good pain relief starts right away, but it only lasts 1 to 2 hours.
  • Although you can move, you might not be able to walk if the medicine used affects motor function.
  • It can lower your blood pressure, which can slow your baby's heartbeat. Fluids given through IV are given to lower this risk. Fluids can make you shiver. But women in labor often shiver with or without epidural.
  • If the covering of the spinal chord is punctured, you can get a bad headache. Treatment can help the headache.
  • Backache for a few days after labor.
  • Epidural can prolong the first and second stages of labor. If given late in labor or if too much medicine is used, it might be hard to push when the time comes. Studies show that epidural increases risk of assisted vaginal delivery.
Pudendal block – A doctor injects numbing medicine into the vagina and the nearby pudendal nerve. This nerve carries sensation to the lower part of your vagina and vulva. This is only used late in labor, usually right before the baby's head comes out. With a pudendal block, you have some pain relief but remain awake, alert, and able to push the baby out.
  • The baby is not affected by this medicine and it has very few disadvantages.



Source:, Office of Women's Health, U.S. Department of Health and Human Services. Content last updated Sept. 27, 2010.


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