Options for managing pain during childbirth

by Kaiser Permanente |
Doctor and partner helping pregnant person with labor pain.

Concerns about managing pain during labor are very common. Every birth experience is unique and can be unpredictable, so it’s important to be flexible and prepared for a variety of possibilities. Knowing your options for managing and coping with pain during labor and childbirth will help you make the right decisions for you and your body.

Attending a childbirth preparation class or doing a tour can help you learn more about the birthing process and your options in more detail. They can also help you develop coping skills in advance, so you’re more prepared when you go into labor. You can also ask your prenatal clinician about any questions that you may have when working on your birth preferences.

Getting emotional support from your partner or other birth support person can be a great help in controlling your pain. This type of support can lower your stress and anxiety, so you can more easily reduce your discomfort, pain, or pressure.

Coping with pain

Other strategies for decreasing pain and anxiety in labor include:

  • Aromatherapy
  • Breathing exercises
  • Guided meditation
  • Hot and cold packs
  • Hydrotherapy
  • Music therapy
  • Walking and frequent position changes

A transcutaneous electrical nerve stimulation (TENS) unit can also be helpful, especially for early labor. This handheld device delivers electricity directly to your nerves through pads fixed to your lower back.

Sterile water injections can help with back labor pain too, providing relief for around two hours. If you choose this method, your clinician will inject a small amount of sterile water right under the skin at your lower back.

Pain medications

You might choose to receive pain medications during labor and birth. Each has pros and cons:


These drugs are given via injection or an intravenous (IV) line.

PROS: They reduce pain and increase relaxation. You still have full use of your muscles to push during childbirth. At a later point, you can use additional pain medications, such as an epidural, if you need to.

CONS: They may not be strong enough, or they may cause drowsiness, difficulty concentrating, nausea, or vomiting. To keep your baby safe, they can only be used during the earlier part of labor.

Nitrous oxide

Also called “laughing gas,” you inhale this medicine through a mask that you hold up to your face.

PROS: It can be started and stopped easily. You can use this anytime, and the medication itself won’t reach your baby. It has few side effects and can help reduce pain and anxiety.

CONS: It might not be as strong as other pain relief medications, and it only works while you’re breathing it in. It can also make you feel dizzy or “spaced out.”

Epidural block

This medication is injected through a small tube placed in your lower back. You can still feel your lower body and push during birth.

PROS: You’re mostly pain-free from the waist down. The epidural block can be used for hours, and you stay awake and alert.

CONS: It takes time to prepare and 15 to 30 minutes before you feel pain relief. You won’t be able to walk, and you’ll need a catheter to help drain your bladder. It may cause you to have a headache or experience a drop in blood pressure. It can also cause the final stage of labor, which is the birth of your baby, to take longer.

Spinal block

This medicine is given in a similar way as an epidural block, but only for Cesarean births (C-sections).

PROS: You’ll get immediate pain relief and will stay awake and alert throughout the birth.

CONS: This only works for an hour or two, and you won’t be able to walk during that time.

Local anesthetics

At the time of birth, local anesthetics may be used to numb the vaginal area. This can prove especially helpful if in the rare occurrence that you need forceps, a vacuum, or an episiotomy, which is an incision in the vaginal opening to help the baby pass through. Kaiser Permanente clinicians and nurse-midwives do everything possible to avoid these aids during birth.

If you have any questions about how you can manage pain during birth, be sure to ask your care team.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.