Written by:

Dr Elliott Ridgeon

BA (Oxon), BMBCh

Dr Ridgeon is an anaesthetist in the Oxford School of Anaesthesia. He studied at the University of Oxford, and has a research interest in trials in Critical Care. Elliott’s daily practice is spent on busy hospital labour wards, providing anaesthesia and analgesia for pregnant mothers, alongside general duties in the operating theatres and Intensive Care Unit.

How painful is childbirth and will I need pain relief?

In this article:

  • What are the methods of pain relief?
  • Will pain relief affect my baby?
  • How will pain relief affect my labour and recovery?
  • Main Points

How painful is childbirth and will I need pain relief?

Childbirth and labour can be very painful! Some women are able to manage with no pain relief at all, but many find they need medical or non-medical techniques to help them through.

What are the methods of pain relief?

These are usually divided into non-medical and medical (or “chemical”) options.

Non-medical

  • Breathing techniques: Controlling and focusing the breathing pattern to aid relaxation and alleviate pain.
  • Hypnobirthing: self-hypnosis and hypnotherapy to control and overcome the pain of labour and childbirth.
  • TENS machines: stands for Transcutaneous Electrical Nerve Stimulation. A machine that delivers small electrical currents via sticky pads to areas on the skin, causing a tingling sensation, which reduces pain signals to the brain and relaxes muscles.
  • Acupressure and massage: pressure applied to muscles and other points on the body to relieve tension and improve relaxation.
  • Aromatherapy: scented oils used as fragrance, in bathing or massage to aid relaxation.

Medical

  • Oral painkillers (paracetamol, codeine): tablets or liquids given at regular intervals to reduce pain. Codeine is related to morphine, and can be very strong if your genetics mean your body processes it very rapidly.
  • Injected painkillers (diamorphine): an injection into the muscle (similar to the needle used for a vaccination) of a morphine-like substance; a strong painkiller. Pethidine is similar, and is also sometimes used. However, many hospitals now prefer diamorphine as pethidine can have more side-effects.
  • Entonox (gas and air): a fast-acting mixture of nitrous oxide (N2O) and oxygen that is breathed in through a mouthpiece.
  • Epidural: an injection in the back to put a small tube in place, down which painkillers and anaesthetic (numbing) solution can be given, to work directly on nerves. Top-ups can be given at regular intervals once the tube is in place, without further needles.
  • Spinal: a single-shot injection to the back, with painkillers and anaesthetic (numbing) solution placed directly on nerves.
  • Patient Controlled Analgesia (PCA, an intermittent IV injection, usually Remifentanil): IV injections of rapid-acting painkillers related to morphine, controlled by a button pressed by the patient whenever they feel pain.

You can potentially have all of these during labour and childbirth, and you can ask for pain relief in labour at any time, regardless of your original birth plan. However, some types have certain risks and are used only in specific circumstances, and some can only be given in hospital.

Healthcare professionals (midwives, obstetricians, and anaesthetists) will advise you on which methods are appropriate for you. Not all forms of pain relief will work for all people, so you may have to try one or two before you find the best.

See the separate articles for more detail on the methods of pain relief, including risks and benefits.

Will pain relief affect my baby?

It is very unlikely that pain relief as described above will affect your baby. Methods used in pregnancy, labour and childbirth are designed to be as risk-free as possible for mother and baby.

How will pain relief affect my labour and recovery?

All forms of pain relief carry some side effects. In particular, opioids (morphine-like drugs) can cause itching, nausea, and vomiting. However, they are excellent painkillers. Some research suggests that epidurals are linked to an increased need for forceps/ventouse delivery, but the nature of this relationship is not clear. Epidural risks are discussed in detail in the epidural article.

If you require any kind of surgical intervention (e.g. C-section, episiotomy, repair of a tear to the perineum), pain relief will be essential to the safe conduct of the procedure itself. Pain relief will also be necessary in your recovery, as it will allow you to mobilise, care for your new baby, and get back on your feet.

Many millions of women have a normal labour, delivery and recovery both with and without pain relief. It is not “unnatural” to ask for pain relief, nor is it a failure to feel that you need it during labour or delivery.

Main Points

  • Many women find they need pain relief during labour and childbirth.
  • Pain relief is typically split into medical and non-medical methods.
  • Non-medical methods include breathing techniques, hypnobirthing, Tens Machines and massage.
  • Medical pain relief methods suitable for childbirth include oral pain killers, injected pain killers, Entonox, epidural, spinal and PCA.
  • Pain relief methods are designed to be as risk-free as possible for both mother and baby.
  • All forms of pain relief carry some side effects, but each method will be discussed with you before use.
  • You can choose to have pain relief at any time during labour, even if you have planned to have a drug free birth.