Pain relief options

peas

during labor and delivery

As you approach the end of your pregnancy, you may be worried about how you'll cope with the pain during labor and delivery. While all women experience some discomfort during childbirth, pain medications, breathing techniques, and other methods can provide relief.

Deciding on a plan

nurse and pregnant ladyYou and your practitioner can decide on your pain relief plan by carefully considering your comfort and delivery preferences and the baby's safety at the time of birth.

Even if you prefer to give birth naturally, you should be aware of the types of pain medicines available to you in case they become necessary.

No matter what pain management options you choose, you should learn a few simple breathing and relaxation techniques that can help you throughout your labor.

Download or listen online to our childbirth audio program to guide you through these exercises.

Childbirth preparation classes will also teach you ways to help you and your partner prepare for the big moment.

Medications

  • Epidural (regional anesthesia). An epidural injection partially or fully numbs the lower body by delivering a dose of pain medication into the lower back around the spinal cord. The amount of discomfort or pain that you will feel during delivery depends on the amount of anesthetic used. Less anesthetic (often called a light epidural) allows you to feel enough to push effectively and be more active in your labor. With more anesthetic, you will feel little or no pain from your contractions, but this lack of feeling can make it harder to push. Epidurals are also used during a cesarean delivery (C-section) to numb the belly while allowing you to stay awake during the birth of your baby. If you're unsure whether to get an epidural, use this epidural decision tool.
  • Spinal block. This is another type of regional anesthesia that quickly and completely numbs the pelvic area for a C-section. No pushing is possible with a spinal block.
  • Local anesthesia. This injection of pain medication is used to numb a small area before inserting an epidural needle or before making an incision (episiotomy) that widens the vaginal opening for the birth.
  • Narcotics (opioids). These drugs are used to reduce anxiety, help you relax between contractions, and decrease the pain, but not block it completely. Because they can affect a newborn's breathing, opioids are usually given well before delivery.
  • Pudendal and paracervical blocks. These are injections of pain medication into the pelvic area to reduce labor pain. A pudendal block is one of the safest forms of anesthesia for numbing the area where the baby will come out. It can be helpful with fast labor when a little pain medicine is needed close to delivery. It does not affect the baby. Paracervical blocks have been generally replaced by epidurals, which are more effective.
  • General anesthesia. General anesthesia, which makes you unconscious, is used only in rare cases such as when an emergency C-section is necessary and an epidural line has not been installed in advance.

Other types of relief

  • Continuous labor support. Women who have continuous one-on-one support (for example, from a spouse, family member, labor partner, doula, nurse, midwife, or childbirth educator) from early labor until after childbirth are more likely to give birth without pain medication and are less likely to describe their birthing experience negatively. Having a support person can help you feel more in control with less fear, which are strong elements of mental pain control.
  • Focused breathing. Breathing in a rhythm can take your focus away from pain during contractions. Deep breathing can help you relax between contractions.
  • Imagery. Imagery is using your imagination to create a sensory experience to decrease pain. For instance, you can visualize the contractions as waves rolling over you or picture a peaceful place, such as a beach or mountain stream, to help you relax between contractions. Use our childbirth audio program to guide you through these exercises.
  • Hypnosis. This is a low-risk way of managing labor pain and anxiety that works for some women.
  • Distraction. During early labor, walking, playing cards, watching TV, taking a shower, reading a book, or listening to music can help take your mind off your contractions. Make sure to add any items like music, pillows, or special objects that you plan to bring from home to your hospital checklist.
  • Acupuncture. Acupuncture may be a low-risk, effective way of managing labor pain for some women, according to a few studies.
  • Massage. Massage of the shoulders and lower back during contractions may ease your pain. Strong massage of the back muscles during contractions may help relieve the pain of back labor. Tell your labor coach exactly where and how hard to push.
  • Laboring in water. This helps with pain, stress, and sometimes slow, difficult labor.

Things to remember

  • The choice to use — or not use — pain medication during delivery is personal. Your decision may be influenced by your tolerance for pain, how you want your baby to enter the world, and religious and cultural beliefs.
  • Once you and your doctor or nurse decide on a pain management program, be sure to add it to your birthing plan.
  • It's okay to change your mind. As you get closer to labor, you may reconsider your options and choose a different pain relief method.
  • Be prepared to be flexible. Your doctor may need to adjust your plan once you begin labor. Know that your delivery team will do their best to follow your wishes, while keeping the well-being of you and your baby as their most important priority.

Find more ways to prepare for labor.

Source: Adapted from copyrighted material of The Permanente Medical Group, Inc.

Reviewed by: Jeff Convissar, MD, November 2015
Additional Kaiser Permanente reviewers

© 2015 Kaiser Permanente

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