Managing Pain in Labour

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You may not know how birth will feel until the day. If you experience any pain, there are many different techniques you can use to help manage this.

Breathing Techniques

Effective breathing techniques maximise oxygen for you and your baby, slow your pulse rate and lower your blood pressure.

Learning to focus the breath during labour reduces stress hormones and anxiety. It also relaxes the muscles around your womb and reduces pain. Ask your midwife where you can learn these techniques.

Entonox (Gas and Air)

Entonox is inhaled, or breathed in, through a mouthpiece. It’s a combination of oxygen and nitrous oxide. It won’t remove all pain, but it can reduce how much pain you feel..

It takes about 15 to 20 seconds to work from when you start to inhale it. You are completely in control of how much entonox you use. Once you stop breathing it, it wears off quickly. This is available in all birth settings.

Side effects of Entonox

We do not know of any side effects for your baby.

Pethidine, Diamorphine and Meptazinol

These drugs are given as an injection, usually into your thigh. They may not remove the pain but can make you feel more relaxed.

They take about 20 minutes to work, and last between 2 and 4 hours.

Side effects of Pethidine, Diamorphine and Meptazinol

These medications can make you feel sick, light-headed and forgetful. Given too close to birth it can affect your baby’s breathing. If this happens your baby can be given another drug to reverse the effects. Your baby may be more sleepy after birth, which can interfere with the baby’s first feed.

Pethidine and diamorphine are available in all hospital settings. Meptazinol is not available at all hospitals – check with your midwife.


Epidural is a type of local anaesthetic which numbs the nerves that send pain signals to your brain. It can only be given by an anaesthetist and therefore you cannot have an epidural at home or in a midwife-led birth centre.

The epidural is a package of care. This is what you can expect:

You will sit in a curled position whilst the anaesthetist numbs the area to introduce the needle into your back. A skinny tube is then introduced through the needle, which will be left in place to give you the local anaesthetic. An epidural can lower your blood pressure so you will need an intravenous drip running with extra fluids.

Continuous monitoring of your baby will be recommended. Most people need a catheter (a tube into your bladder to drain the urine) as you lose the sensation of needing to pee.

An epidural is a skilled procedure and can take 10 minutes to set up, or much longer. It will take a further 15-20 minutes for the effects to be felt. An epidural can provide very good pain relief, but it’s not always completely effective in labour.

Side effects of an epidural

  • The contractions may slow down. Therefore, you may need another drug to speed them up.
  • You may have an increased chance of needing help to give birth with forceps or a ventouse as the epidural makes it harder to know how to move your baby down.
  • You will need to wait until the epidural has worn off before standing up.


You can use a birth pool for comfort during labour and either stay in it or get out to give birth to your baby.

Being in water helps you change positions easily as the water will take some of your body weight. Warm water relaxes muscles and helps the perineum to stretch which can reduce tearing. It also produces endorphins – your body’s natural painkillers.

Your baby is already in water and will find the birth into a pool a very gentle journey into life outside of the womb. If you are birthing at home, you can hire a birth pool.  Most midwifery-led units offer pools, and some consultant-led units also offer waterbirth.

All options will be available to you when you are in labour. If your choice changes, you can discuss this with your midwife at the time.

Your labour, birth and how you will feel may change constantly. Being aware of all of your options will allow you to make informed decisions at the time.

Explanation Point

Oxygenone of the main elements that make up the air we breathe. It is necessary for the survival of all humans, plants and animals.
Nitrous oxidea colourless gas commonly used as a painkiller in medicine and dentistry.
Anaesthetica drug which causes loss of feeling.
Anaesthetistsspecialist doctors who give patients anaesthetics before operations and procedures.
Forcepssmooth metal instruments that look like large spoons or tongs. They're curved to fit around the baby's head. The forceps are carefully positioned around your baby's head and joined together at the handles. With a contraction, an obstetrician gently pulls to help deliver your baby.
Ventousea ‘vacuum cup’, which is attached to the baby's head by suction. During a contraction, the obstetrician or midwife gently pulls to help deliver your baby.
Perineumthe area between your vaginal opening and your rectum.
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